Pharmacological Treatment of Syphilis

Penicillin-Based Therapy: First-Line Treatment

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It progresses through multiple stages and can have serious health consequences if untreated. The preferred and most effective pharmacological treatment remains penicillin-based therapy.

Why Penicillin?

Penicillin has been the gold standard for treating syphilis since its introduction. It is highly effective in eradicating Treponema pallidum and preventing disease progression.

Types of Penicillin Used:

• Benzathine Penicillin G: First-line treatment for primary, secondary, and early latent syphilis.
• Aqueous Crystalline Penicillin G: Used for neurosyphilis and congenital syphilis.
• Procaine Penicillin G: Alternative therapy in specific cases.

Dosage and Administration

The recommended regimen depends on the stage of infection. For early syphilis, a single intramuscular injection of Benzathine Penicillin G (2.4 million units) is sufficient. Late latent syphilis or tertiary syphilis requires three doses administered at weekly intervals.

Alternative Treatments

For penicillin-allergic patients, alternatives such as doxycycline or ceftriaxone may be used. However, penicillin desensitization is recommended for pregnant individuals to ensure effective treatment.

Follow-Up and Monitoring

Patients should undergo serologic testing at 6 and 12 months post-treatment to confirm therapeutic success.

Conclusion

Penicillin remains the most reliable treatment for syphilis, effectively halting disease progression and reducing transmission. Early diagnosis and adherence to treatment protocols are crucial in managing this infection.