Pharmacological Treatment of Syphilis

Introduction

Syphilis is a sexually transmitted infection caused by Treponema pallidum. Effective treatment requires appropriate antibiotic therapy to eliminate the infection and prevent complications.

First-Line Antibiotic Therapies

Penicillin-Based Treatment

Penicillin remains the gold standard for syphilis treatment. Benzathine penicillin G is the preferred drug for all stages except neurosyphilis.

• Early syphilis: Single intramuscular dose of Benzathine penicillin G (2.4 million units).
• Late latent syphilis: Three weekly doses of Benzathine penicillin G (2.4 million units each).
• Neurosyphilis: IV penicillin G (18-24 million units/day for 10-14 days).

Alternative Antibiotics for Penicillin Allergy

For patients allergic to penicillin, alternative antibiotics include:

• Doxycycline: 100 mg orally twice daily for 14 days.
• Ceftriaxone: IV or IM administration based on clinical judgment.
• Azithromycin: Considered for select cases but not first-line due to resistance concerns.

Monitoring and Follow-Up

Post-treatment serologic testing is essential to ensure disease resolution. Patients should undergo periodic follow-ups to assess therapeutic response and prevent relapse.

Conclusion

Penicillin-based regimens remain the most effective pharmacological treatment for syphilis. Alternative antibiotics are available for those with contraindications, ensuring comprehensive care.