Medication
The recommended treatment for primary, secondary or early-stage latent syphilis — which refers to an infection within the last year — is a single injection of penicillin. If you've had syphilis for longer than a year, you may need additional doses.
Self-care
Tetracycline can be used to treat primary, secondary, and latent stages of syphilis. Ceftriaxone may be effective against primary, secondary, and latent stages of syphilis, but the optimal dose has not been established.
Nutrition
Key principles for the treatment of syphilis include the following: Penicillin is the drug of choice to treat syphilis. Doxycycline is the best alternative for treating early and late latent syphilis. Syphilis associated with HIV infection does not require any enhanced antimicrobial therapy.
What is the treatment for latent syphilis?
Patients with treated primary or secondary syphilis. Patients treated for primary and secondary syphilis should have follow-up VDRL testing at 6, and 12 months after treatment. Patients with HIV infection should be monitored at 3, 6, 9, and 12 months, as they are known to have more rapid progression of disease.
Which medications are used in the treatment of syphilis?
What are the key principles of treatment for syphilis?
What is the follow-up care for primary and secondary syphilis?
Which drug is the treatment of choice for syphilis?
The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis.
What is the best treatment for secondary syphilis?
Treating and curing syphilis Primary and secondary syphilis are easy to treat with a penicillin injection. Penicillin is one of the most widely used antibiotics and is usually effective in treating syphilis. People who are allergic to penicillin will likely be treated with a different antibiotic, such as: doxycycline.
Which is first line drug for early syphilis treatment?
RECOMMENDATION 1. In adults and adolescents with early syphilis, the WHO STI guideline recommends benzathine penicillin G 2.4 million units once intramuscularly over no treatment.
Can syphilis be treated in latent stage?
The treatment recommendation for adults and adolescents with late latent syphilis or latent syphilis of unknown duration is: Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units administered intramuscularly each at weekly intervals.
What is Latent syphilis?
Latent syphilis is defined as syphilis characterized by seroreactivity without other evidence of primary, secondary, or tertiary disease. Persons who have latent syphilis and who acquired syphilis during the preceding year are classified as having early latent syphilis (early nonprimary, nonsecondary).
What is benzathine penicillin used for?
Penicillin G benzathine injection is used to treat bacterial infections (eg, mild to moderate infections of the upper respiratory tract, syphilis, yaws, bejel, pinta). It is also used to prevent rheumatic fever, chorea, rheumatic heart disease, or acute glomerulonephritis. This medicine is an antibiotic.
Is azithromycin good for syphilis?
Single-dose oral azithromycin is effective in treating syphilis and may be particularly useful in developing countries in which the use of penicillin G benzathine injections is problematic.
Can ampicillin be used to treat syphilis?
Tanizaki et al. (8) reported that treatment with oral amoxicillin (3 g) and probenecid (750 mg) was highly effective in and well tolerated by syphilis patients with HIV infection.
How do you take azithromycin for syphilis?
A single, 2 g dose of oral azithromycin is just as effective as intramuscular penicillin G benzathine for the treatment of early syphilis, regardless of HIV status, researchers from the UK and Tanzania report (N Engl J Med 2005; 353: 1236–44).
What is the treatment for tertiary syphilis?
Late syphilis, including late latent and tertiary syphilis, are treated with one weekly injection of penicillin for three consecutive weeks. For individuals with neurosyphilis, treatment involves higher doses of intravenous penicillin for about 10 to 14 days.
How much doxycycline should I take for syphilis?
However, multiple therapies might be effective for nonpregnant persons with penicillin allergy who have primary or secondary syphilis. Doxycycline (100 mg orally 2 times/day for 14 days) (600,601) and tetracycline (500 mg orally 4 times/day for 14 days) have been used for years and can be effective.
How is latent syphilis diagnosed?
Latent syphilis can only be diagnosed by serological tests. In fact, in North America, the majority of syphilis cases are identified at the latent stage by serological tests. The sensitivity and specificity of serological tests vary depending on the type of test and stage of the disease (Table 1).
What is the best treatment for syphilis?
Bicillin L-A, taken as an intramuscular injection, is the main treatment for syphilis. Francois Guillot/Getty Images. The recommended treatment for syphilis is the antibiotic penicillin, specifically the type known as penicillin G benzathine, sold as Bicillin L-A in the United States. Penicillin has proven to be effective at killing Treponema ...
What antibiotics are used for syphilis?
While penicillin is the drug of choice for syphilis, other antibiotics may be used in nonpregnant individuals who are allergic to penicillin. The CDC recommends that penicillin-allergic patients be treated in consultation with an infectious disease specialist. Alternatives to penicillin include the following: 1 Doxycycline can be used to treat primary, secondary, and latent stages of syphilis. 2 Tetracycline can be used to treat primary, secondary, and latent stages of syphilis. 3 Ceftriaxone may be effective against primary, secondary, and latent stages of syphilis, but the optimal dose has not been established. 4 Azithromycin is effective against primary and secondary syphilis, but its use is limited in the United States because of antibiotic resistance.
How long does it take for penicillin to desensitize?
Desensitization typically involves taking steadily increasing doses of the penicillin over 4 to 12 hours, starting with a very small dose, to allow you to tolerate it safely. If you're treated for syphilis during your pregnancy, your newborn baby should be evaluated for congenital syphilis and may also need to receive antibiotic treatment.
How long does penicillin last?
If neurosyphilis — syphilis affecting the brain or spinal cord — is diagnosed, an intensive regimen of penicillin lasting 10 to 14 days is necessary, and it may need to be repeated in some individuals. If you're allergic to penicillin, your doctor will suggest another antibiotic, but penicillin is the only recommended treatment for pregnant women ...
What is the reaction to penicillin called?
Jarisch-Herxheimer Reaction to Penicillin. You may experience what's called a Jarisch-Herxheimer reaction — often shortened to “a Herxheimer reaction” or just “herxing” — on the first day you're treated for syphilis.
What are some alternatives to penicillin?
Alternatives to penicillin include the following: Doxycycline can be used to treat primary, secondary, and latent stages of syphilis. Tetracycline can be used to treat primary, secondary, and latent stages of syphilis. Ceftriaxone may be effective against primary, secondary, and latent stages of syphilis, but the optimal dose has not been ...
Is syphilis contagious in the primary?
Syphilis is contagious in the primary and secondary stages and may be contagious in the early latent stage, so both current and past sexual partners are at risk. You can notify your sexual partner (or partners) yourself, or you can do it anonymously through a partner service program.
What test can confirm syphilis?
Blood. Blood tests can confirm the presence of antibodies that the body produces to fight infection. The antibodies to the syphilis-causing bacteria remain in your body for years, so the test can be used to determine a current or past infection. Cerebrospinal fluid.
How to prevent HIV infection?
Avoid sexual contact with new partners until the treatment is completed and blood tests indicate the infection has been cured. Notify your sex partners so that they can be tested and get treatment if necessary. Be tested for HIV infection.
Can you cure syphilis with penicillin?
When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you're allergic to penicillin, your doctor may suggest another antibiotic or recommend penicillin desensitization.
Nontreponemal Tests and Traditional Algorithm
False-positive nontreponemal test results can be associated with multiple medical conditions and factors unrelated to syphilis, including other infections (e.g., HIV), autoimmune conditions, vaccinations, injecting drug use, pregnancy, and older age ( 566, 569 ).
Treponemal Tests and Reverse Sequence Algorithm
The majority of patients who have reactive treponemal tests will have reactive tests for the remainder of their lives, regardless of adequate treatment or disease activity. However, 15%–25% of patients treated during the primary stage revert to being serologically nonreactive after 2–3 years ( 570 ).
Cerebrospinal Fluid Evaluation
Further testing with CSF evaluation is warranted for persons with clinical signs of neurosyphilis (e.g., cranial nerve dysfunction, meningitis, stroke, acute or chronic altered mental status, or loss of vibration sense).
Special Considerations
Parenteral penicillin G is the only therapy with documented efficacy for syphilis during pregnancy. Pregnant women with syphilis at any stage who report penicillin allergy should be desensitized and treated with penicillin (see Management of Persons Who Have a History of Penicillin Allergy).
Management of Sex Partners
Sexual transmission of T. pallidum is thought to occur only when mucocutaneous syphilitic lesions are present. Such manifestations are uncommon after the first year of infection.
What is the best treatment for syphilis?
Penicillin is the drug of choice to treat syphilis. Doxycycline is the best alternative for treating early and late latent syphilis. Syphilis associated with HIV infection does not require any enhanced antimicrobial therapy.
How long after syphilis treatment should you have a VDRL test?
Patients treated for primary and secondary syphilis should have follow-up VDRL testing at 6, and 12 months after treatment. Patients with HIV infection should be monitored at 3, 6, 9, and 12 months, as they are known to have more rapid progression of disease.
How long does ceftriaxone last?
A 10- to 14-day trial of ceftriaxone is effective for treating early syphilis, although the optimal dose and duration have not been established. Doxycycline and tetracycline for 28 days have been used for many years and are the only acceptable alternatives to penicillin for the treatment of latent syphilis.
How long does it take for a spirochete to clear?
The reaction is common, develops within several hours after beginning antibiotic treatment, and usually clears within 24 hours after onset. Its exact etiology is unclear, although it may be due to an immunological reaction to the rupture of spirochetes.
Is penicillin a syphilis drug?
Penicillin. Penicillin was established as an effective treatment for syphilis before the widespread use of randomized clinical trials. [ 26] . The treatment guidelines published by the CDC (see current CDC recommendations) are based largely on uncontrolled trials and expert opinion.
What is the primary goal of prevention?
The primary goal of prevention is to limit the spread of syphilis. This entails counseling patients to use safe sex practices and advising patients who abuse intravenous (IV) drugs to never share needles and to use clean needles. Notification and treatment of sexual partners and exposed drug partners are paramount.
Can CSF be used for neurosyphilis?
CSF testing to detect neurosyphilis is strongly recommended in patients with tertiary syphilis or with neurological signs or symptoms consistent with neurosyphilis and in patients without symptoms whose serologic titers do not decline appropriately after being treated with recommended therapy.
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Nontreponemal Tests and Traditional Algorithm
- Medication
When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you're allergic to penicillin, your doctor may suggest another antibiotic or recommend penicillin d… - Treatment follow-up
After you're treated for syphilis, your doctor will ask you to: 1. Have periodic blood tests and exams to make sure you're responding to the usual dosage of penicillin. Your specific follow-up will depend on the stage of syphilis you're diagnosed with. 2. Avoid sexual contact with new part…
Treponemal Tests and Reverse Sequence Algorithm
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Cerebrospinal Fluid Evaluation
- Finding out you have syphilis can be extremely upsetting. You might experience anger if you feel you've been betrayed, or shame if you think you've infected others. However, hold off placing blame. Don't assume that your partner has been unfaithful to you. One (or both) of you may have been infected by a past partner.