Pharmacological Treatments for Syphilis

Treatment Guidelines for Different Stages of Syphilis

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Early diagnosis and appropriate pharmacological treatment are critical to prevent complications.

Early Syphilis (Primary and Secondary)

First-line treatment: Intramuscular Benzathine Penicillin G (2.4 million units, single dose)
Alternative for penicillin allergy: Doxycycline (100 mg orally twice daily for 14 days) or Azithromycin (2 g orally, single dose)

Latent Syphilis

Early latent syphilis: Same as primary and secondary syphilis
Late latent or unknown duration: Benzathine Penicillin G (2.4 million units IM weekly for 3 weeks)
Alternative: Doxycycline (100 mg orally twice daily for 28 days)

Neurosyphilis

First-line treatment: IV Aqueous Crystalline Penicillin G (18-24 million units/day for 10-14 days)
Alternative: Ceftriaxone (2 g IV daily for 10-14 days)

Special Considerations

Pregnant individuals should receive Penicillin G as the treatment of choice, as alternative antibiotics may not be effective in preventing congenital syphilis.