Treatment of syphilis (syphilis) consists in administering antibiotics that destroy the bacteria Treponema pallidum responsible for the development of the disease. Antibiotics (most often penicillin, doxycycline, tetracycline) are injected intramuscularly for at least two weeks. Late syphilis, which affects the nervous system, requires hospital treatment. See how to treat syphilis in the primary, secondary and late stages.
Treatment of syphilis (syphilis)consists in administering intravenous or intramuscular antibiotics to the patient. Despite medical advances, the oldest known antibiotic, penicillin, is still used in the treatment of syphilis . Although this compound may cause complications (e.g. allergic reactions, anaphylactic shock), no agent has yet been invented that would more effectively fight the bacteriaTreponema pallidumresponsible for the development of syphilis.
What is the treatment of syphilis and how long does it take?
Treatment of primary syphilis
The primary phase of syphilis is 9-15 weeks after infection. Then the first symptoms of the disease appear (usually after 3 weeks) - the so-called primary lesion, i.e. a painless lump followed by ulceration at the site of the entry of pale spirochete bacteria. If you start treating syphilis at this stage, it will give you the best results.
In the primary phase, the treatment of syphilis consists in administering procaine penicillin in a dose of 1,200,000 IU. daily intramuscularly for 20 days. Procaine penicillin is a type of antibiotic that is a combination of benzathine penicillin with procaine, which, thanks to its analgesic properties, reduces the feeling of pain during injection. The substance has a prolonged duration of action, so it can be administered at less frequent intervals.
Treatment of secondary syphilis
In Poland, the standard treatment is the treatment of syphilis with procaine penicillin, which, thanks to daily injections, allows you to maintain a high level of the active substance. This method increases the effectiveness of the treatment.
It sometimes happens that the primary skin lesions are very small and, additionally, they do not hurt, which makes it difficult to locate them. As a result, the patient does not even know that he has become infected. Untreated primary syphilis goes into a phasesecondary, which manifests as a red rash in the form of spots and papules located most often on the feet, hands and head.
Treatment of syphilis at this stage requires the use of higher doses of the antibiotic for a longer period of time. The patient is usually administered procaine penicillin intramuscularly for 30 days. It can be replaced by benzathine penicillin, which is given every 4 days in doses of 2,400,000 IU. (first dose) and 1,200,000 IU (subsequent doses). For secondary syphilis, a total of 9 injections are recommended.
ImportantNotify all sexual partners about the disease!
When you are diagnosed with syphilis, you should notify all past and present sexual partners of your condition. Syphilis is very contagious, especially in the early stages, and can also be spread by kissing. Hence, it is so important that all people with whom we had sexual contact in the 6 months before the infection undergo appropriate tests for the presence of the spirochete.
Treatment of syphilis with tetracycline, doxycycline and erythromycin
If you are allergic to penicillins, other antibiotics can be used to treat syphilis. For this purpose, tetracycline, doxycycline, erythromycin, less often ceftriaxone, azithromycin are used. Their dosage regimen is usually as follows:
- tetracycline: daily dose 4 x 500 mg;
- doxycycline: daily dose 2 x 100 mg;
- erythromycin: 4 x 500 mg daily dose.
Treatment of syphilis with these antibiotics should last 14 days.
Please note that the above recommendations are indicative only - each case is different and the treatment schedule should always be decided by the attending physician.
Treatment of late syphilis and hospital treatment of nervous system syphilis
Treatment of late syphilis, i.e. more than 2 years after infection, consists in administering procaine penicillin in a dose of 1,200,000 IU. for a period of 30 days. However, if pale spirochete bacteria are found in the cerebrospinal fluid, treatment should be in the hospital. Syphilis of the nervous system requires the administration of crystalline penicillin intravenously 4 times a day at a dose of 6,000 IU. for a period of about two weeks. After leaving the hospital, treatment is continued with intramuscular injections in a daily dose of 1,200,000 IU. for the next 15-20 days.
Worth knowingTreatment of syphilis with mercury
The first substance used to treat syphilis was mercury. Although this method was ineffective and very dangerous, it was very popular in the 16th and 17th centuries. The sick were placed in special furnaces or vats,where they were dusted with mercury vapor or taped with mercury patches on their skin. Another way was to smear the skin with mercury ointment and then sit the sick person on the steam bath. This regimen was repeated for several weeks, and its effects were often more severe for patients than the symptoms of syphilis itself.
The treatment of syphilis with mercury was discontinued only after the discovery in 1905 of the spirochete bacterium, the direct cause of the disease. At that time, the first drug was introduced - salvarsan, which destroyed microorganisms, but on the other hand caused very severe side effects and did not prevent the relapse of the disease. It was soon replaced by a milder agent, neosalvalsan. However, it was not until the discovery of penicillin in 1938 that made a breakthrough in the treatment of syphilis.
Treatment of syphilis in people with HIV
In people infected with HIV, the treatment of syphilis should always follow the same scheme as in the case of nervous system syphilis, i.e. in a hospital and last at least a month.
Side effects of syphilis treatment
Patients may experience adverse reactions during penicillin therapy. The most common are:
- Jarisch-Herxheimer-Łukasiewicz reaction - is not a contraindication to penicillin treatment, because it usually occurs at the beginning of therapy and passes spontaneously. It usually appears 6-8 hours after the injection of the first dose of antibiotic as a reaction to the rapid breakdown of pale spirochetes and the release of toxins by bacteria. Its symptoms are: fever up to 40 degrees C, chills, intensification of skin lesions. It does not pose a serious threat to he alth or life;
- Hoigné reaction - occurs very rarely (in 1-3 patients out of 1000), includes symptoms of a neurological and psychological nature. It manifests itself with severe anxiety, hallucinations, body shocks. They appear from a few seconds to 3 minutes after injection and pass after 15-60 minutes. A mild complication, it does not pose a threat to he alth or life;
- anaphylactic shock - a sudden and severe allergic reaction to penicillin; shock symptoms include chills, pale skin, lowered pulse, shallow breathing, drop in pressure, laryngeal edema, loss of consciousness. Requires immediate medical attention.