Syphilis - primary
Alternative names:
primary syphilis
Treatment:
The treatment of syphilis is determined by the length of time the person has been infected. Primary, secondary, and latent syphilis of less than one year duration are treated as follows: - penicillin G benzathine, 2.4 million units injected into a muscle (IM), as a single dose
- doxycycline, 100 mg (milligrams) by mouth, twice per day for 15 days
- tetracycline, 500 mg by mouth, four times per day for 15 days
- erythromycin, 500 mg by mouth, four times per day for 2 weeks
- ceftriaxone, 250 mg IM, daily for 10 days
For treatment of syphilis of greater than one year duration: - penicillin G benzathine, 2.4 million units IM, weekly for 3 weeks
- doxycycline, 100 mg by mouth, twice per day for 30 days
- tetracycline, 500 mg by mouth, twice per day for 30 days
Neurosyphilis: - aqueous penicillin G ,12 to 24 million units injected into a vein (IV), daily for 10 days; followed by benzathine penicillin 2.4 million units IM, once a week for 3 weeks
- procaine penicillin, 2.4 million units IM, daily for 10 days; given with probenecid, 500 mg by mouth, four times per day for 10 days. This is followed by benzathine penicillin, 2.4 million units IM, once a week for 3 weeks.
Syphilis during pregnancy:
Penicillin is recommended as the only real drug of choice. Tetracycline cannot be used because of toxicity to the fetus, and erythromycin may fail to prevent congenital syphilis in the fetus. Penicillin-allergic individuals should ideally be desensitized and then treated with penicillin.
Several hours following treatment of early stages of syphilis individuals may undergo a reaction called Jarish-Herxheimer reaction. Symptoms of this reaction include: These symptoms usually disappear within 24 hours.
Follow-up blood tests must be done at 3, 6, 12, and 24 months to ensure the infection has been eliminated. There must be abstinence from sexual conduct until 2 follow-up tests have indicated that the infection has been cured. The sexual partner should also be treated. Syphilis is extremely contagious in the primary and secondary stages.
Expectations (prognosis):
Syphilis can be completely cured if diagnosed early and treated thoroughly.
Complications:
Calling your health care provider:
Call for an appointment with your health care provider if you have symptoms suggestive of syphilis. If you have had intimate contact with a person who has syphilis or any other STD, or have engaged in any high risk sexual practices including multiple partners, unknown partners, or IV drug usage you should contact your physician or be screened in a STD clinic.
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