Pharmacological Treatment of Syphilis: Indications, Administration, and Adverse Effects

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. Its treatment primarily involves antibiotic therapy, with penicillin being the preferred choice. However, for patients with a penicillin allergy, alternative treatment options must be considered.

Indications for Treatment

Treatment is indicated for all stages of syphilis, including primary, secondary, latent, and tertiary syphilis. The choice of antibiotic and duration of treatment depend on the disease stage and patient-specific factors.

Administration of Penicillin

The preferred treatment for syphilis is benzathine penicillin G, administered via intramuscular injection. Early-stage infections require a single dose, while late-stage infections may need multiple doses over several weeks.

Alternative Treatment for Penicillin-Allergic Patients

• Doxycycline: Administered orally for 14-28 days, depending on the disease stage.
• Tetracycline: An alternative oral antibiotic for those who cannot take doxycycline.
• Ceftriaxone: Given as an intramuscular or intravenous injection in selected cases.
• Azithromycin: Used less frequently due to concerns about resistance.

Adverse Effects of Treatment

Penicillin and alternative antibiotics may cause side effects, including gastrointestinal disturbances, allergic reactions, and Jarisch-Herxheimer reaction—a temporary worsening of symptoms following treatment initiation due to bacterial endotoxin release.