What are the Different Types of Syphilis Treatment?

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  • Written By: Nick Arteaga
  • Edited By: C. Wilborn
  • Last Modified Date: 11 November 2019
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In nearly all cases, the standard syphilis treatment is the antibiotic penicillin, specifically benzylpenicillin or penicillin G as it is most often called. Parenteral penicillin, which means penicillin administered by injection or intravenously, is usually used instead of penicillin administered orally. Various dosages of penicillin G are used depending on the stage of the disease. Often, only one dose of penicillin is required to treat the early stages of syphilis. Patients who are highly allergic to penicillin may be given other antibiotics, such as tetracycline, but there is some concern about their effectiveness.

Penicillin used to treat diseases is derived from the Penicillium fungi. While several species of this fungi exist, Penicillium chrysogenum is the one used to treat bacterial infections such as syphilis. Besides syphilis treatment, penicillin is the standard antibiotic treatment for other sexually transmitted diseases such as gonorrhea and chlamydia.

Syphilis progresses in three stages: primary, secondary, and tertiary syphilis. Each stage is identified by the amount of time after initial contraction of the disease. Primary syphilis is generally occurs during the first month after contracting the disease, secondary occurs for the next two to six months, while tertiary syphilis sets in after six months. Patients who receive syphilis treatment in the early stages are less likely to have long-term effects.


Other categories of syphilis include latent syphilis, which has no outward indications of the disease, and neurosyphilis, which involves the infection of the central nervous system. Neurosyphilis is especially common in patients infected with the HIV virus. It's important that a stage must be identified when prescribing the correct dose of penicillin for syphilis treatment.

The standard treatment for primary, secondary, and early latent syphilis is a single dose of penicillin. Tertiary and late latent syphilis treatment usually involves weekly doses of penicillin administered for three weeks. Patients with neurosyphilis require more intensive treatment; penicillin is usually given intravenously for up to 14 days. HIV-positive patients who also test positive for syphilis have a higher rate of neurological complications and should be checked for these more frequently. After syphilis has been successfully treated, there is no danger of transmission of the disease.

It is important to note that syphilis treatment, especially in the secondary stage and with HIV patients, can cause side effects. Some patients suffer what is known as a Jarisch-Herxheimer reaction, which can occur when toxins are released by the bacteria as they die. Headache, fever, and muscle pain is common with this reaction, but usually go away after a few hours. This reaction can be treated with over-the-counter pain relievers.


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Post 3

Like all diseases, early diagnosis is important for syphilis symptoms and treatment. The first two stages of syphilis are not too dangerous, but it can cause irreparable damage after the second stage. And the treatment becomes harder too because the antibiotic dose required to kill the bacteria are much larger.

My mom is a nurse and I remember her telling me that if for example two million units of antibiotics are used to treat someone in the early stage of syphilis, seven million units is necessary for tertiary syphilis.

For neurosyphilis, the dose is much higher, something unbelievable like 200 million units if I remember right. That's a lot of antibiotics! It won't be too easy on the system or the kidneys.

Post 2

@burcidi-- The tablet antibiotics do sometimes work. But they have a much higher failure rate than penicillin which is why penicillin is the standard syphilis treatment in medical guidelines. Even penicillin in tablet form is not as effective as penicillin that's administered as an injection or intravenously.

If someone with syphilis is allergic to penicillin, what doctors generally do is something called "desensitization." Instead of giving the patient one single large dose of penicillin, they hook up the patient to a portable pump. The pump stays with the patient for two weeks and continuously pumps very small amounts of penicillin into the body.

This avoids any allergic reactions and treats the syphilis successfully.

Post 1

So does this mean that tablet antibiotics cannot be used for a syphilis antibiotic treatment?

But I read on a forum that someone was protected from syphilis because he was on an antibiotic treatment for something else. That means that tablet antibiotics work too right?

And what if the person is allergic to penicillin and other antibiotics don't work? How will the doctors treat the syphilis infection then?

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