Antibiotic for syphilis: CDC – Syphilis Treatment
Antibiotics, Penicillin, Recovery, & More
Written by WebMD Editorial Contributors
- What Treatments Are Available for Syphilis?
- Will Syphilis Treatment Work If I’m Pregnant?
- Side Effects of Treatment
- After Treatment and Beyond
Sexually transmitted diseases (STDs) are serious business. But if you’ve been told you have syphilis, there’s both good and bad news.
First, the bad news: If you allow the disease to go untreated for several years, it can damage your heart, blood vessels, brain, and nervous system. Syphilis can cause blindness or paralysis. It increases your chances of getting and spreading HIV, the virus that causes AIDS. Over time, it can damage your organs and even lead to death.
And, of course, if you’re not treated, you’ll likely spread the STD to your sexual partner.
The good news: It’s easily treated and curable in its early stages.
The recommended treatment at all stages of this disease is the antibiotic penicillin.
If you’ve been infected for less than a year, you may need just one injection of penicillin to be cured. But you may need more doses if you’ve had syphilis for more than a year.
There are no over-the-counter medications or home remedies that will cure syphilis — only antibiotics can do that.
Yes. If you’re expecting, it’s especially important to seek treatment because you could pass the disease on to your fetus or newborn. Again, your doctor will give you penicillin. If you’re allergic to it, your doctor will have you go through a special process to enable you to take the antibiotic.
If you do spread the STD to your fetus or newborn, it can be very serious and lead to:
- Stillbirth (the baby is born dead)
- Birth defects
- Infant death
- Cataracts
- Deafness
- Seizures
After getting a penicillin injection or taking other antibiotics, you may experience:
- Fever
- Headaches
- Joint or muscle pain
- All of the above, plus nausea and chills
If you do have side effects, they typically only last about 24 hours.
Once you’ve completed your treatment, the antibiotics will kill the bacteria that cause syphilis and prevent any additional problems from occurring because of that particular case. But it’s important to understand that the treatment can’t reverse or heal damage that you’ve already experienced.
Make sure you take all of your medication (pills or additional injections), even if your symptoms go away during treatment.
Your doctor will likely order blood tests or exams to make sure you’re responding to the antibiotics as expected. They may ask you to talk with your sex partners so they may get tested and treated if needed. And, they’ll advise you to be tested for HIV and avoid all sexual contact until blood tests confirm you’re cured.
And remember that getting treatment doesn’t mean you can’t get syphilis again or spread it at a later time. The only way to do that is to avoid having unsafe sex. When you do have sex, always use condoms.
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Syphilis Treatment | Everyday Health
Is Syphilis Curable at Any Stage?
If diagnosed and treated early, syphilis is easily curable.
If you’ve been infected for less than a year, a single injection of penicillin G benzathine can halt the progression of syphilis.
If you’ve had the disease for more than a year, you may need additional doses. But even late-stage, or tertiary, syphilis can be treated, although penicillin cannot reverse any organ damage that has been caused by syphilis.
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 with syphilis.
There are no home remedies to cure syphilis.
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Treatment of syphilis. The first signs of syphilis in women. Syphilis symptoms.
Syphilis –
the most feared disease. Causes it bacterial
the causative agent is a spirochete. Syphilis is transmitted from person to person through sexual contact.
way. Possibility to become infected by household means – through a handshake, contact with
towel, doorknob, etc. – is almost zero.
- History
Syphilis is believed to have arrived in Europe from the Americas. His
brought the sailors of Christopher Columbus, and at the turn of the 15th – 16th centuries in Europe
the first pandemic of this disease broke out, you can read more about it in this historical essay .
Today, when personal protective equipment
available to everyone, and everyone knows about the dangers of STDs, syphilis still strikes
3-4 people out of 1000 population.
- First stage
Approximately 3-4 weeks after unprotected intercourse
a sore appears on the penis of a man. It is called a hard chancre – if you touch it, then
the foundation is solid. Sometimes it looks like a pimple, sometimes like a sore.
crater. She is painless, does not bother. Usually people think that
a chafing, or a bite, or an allergy. Classically, sexual contact is considered
vaginal. But besides him, there can be anal contact, and oral. At
oral infection chancre is formed on the lip or palate. Chancre in anal
hole, patients are often confused with the acute form of hemorrhoids and not always
decide to take tests. Following the appearance of the chancre, the lymph nodes increase,
but a person may not feel it. If the patient has a chancre and
consulted a doctor – syphilis can be cured in the first stage.
- Second stage
decrease. But after about six months – and given the wide reception
antibiotics can take a year, and a year and a half – a person develops
nonspecific skin rashes. Even doctors can sometimes take them for
an allergic reaction, and by that time the patient had already forgotten about that sore
(chancre), which did not bother him at all. Papules appear on the palms – nodules
Red. Leukoderma develops around the neck – what used to be called the “necklace
Venus.” Today there are many erased forms of secondary syphilis, instead of
classic “necklace of Venus” there are 2-3 incomprehensible spots that do not
even a doctor can always recognize. If not diagnosed, syphilis
develops further.
- Third stage
Tertiary syphilis is characterized by gummous changes in
tissues. Gumma (syphilitic granuloma) is a node
in tissues, in which spirochetes are concentrated. Most gummas occur in the liver,
soft tissues, in the wall of the aorta.
Tissues are irreversibly destroyed, rough
nodes. If the spirochete enters the trunks of the nervous system, it develops
extremely dangerous condition – neurophysilis. However, the dorsal tabes (a form of late
neurosyphilis, characterized by damage to the central nervous system) now
practically never occurs. The artist Mikhail Vrubel suffered from dorsal dryness –
that’s where his demons came from.
- Wide
warts
Broad warts should not be confused with genital warts
condylomas, which occur with the human papillomavirus. Earlier
wide-ended condylomas arose at stages 2 and 3 of syphilis. But now, whether in
due to the widespread use of antibiotics, or for some other reason
warts can occur in the first stage. Due to the difference in the anatomy of the genital
men’s organs detect warts more easily than women. If you see or
feel that condyloma has appeared on the genitals – do not try
to determine on the Internet whether it is broad-nosed or not, immediately go to the doctor.
- Syphilis test
3 weeks after casual intercourse without means
protection (including oral and anal contact), it is necessary to pass a specific
RW analysis (reaction
Wasserman, or simply “analysis for syphilis”). It makes no sense to take an analysis earlier, because
the immune response of the body has not yet developed, and the analysis can give
false negative response. An analysis for syphilis can be taken in any private
laboratory, but it is best to contact the dispensary at the place of residence.
It is important to understand – if a syphilis infection has occurred, the RW analysis will always be
positive. In only 1 out of 10 patients, the syphilis marker disappears after
conducting a course of treatment. The presence of a marker (positive RW assay) may cause unnecessary
questions during hospitalization, obstetrics, professional examinations for
work. Therefore, a sick person needs to undergo only legal
treatment in a state medical institution licensed for treatment
syphilis.
Such an institution will issue a certificate to the patient stating that syphilis was,
the patient underwent a course of treatment, was registered and deregistered, healthy. none
a private clinic has no right to treat syphilis and issue such certificates!
A private clinic can only make a diagnosis and refer the patient to
state medical institution.
- Treatment of syphilis
Today, all over the world, syphilis is easily treated with prolonged
antibiotics of the penicillin series, which until recently were available
and in Russia. Treatment of syphilis with prolonged antibiotics is only 4
extencillin injections. But now in Russia this drug is not available, and in
treatment of syphilis using bicillin or penicillin – 6 injections daily in
within 10 days, the treatment is difficult. The task of the state is to make the patient not
contagious to society. Everywhere in the world, when syphilis is detected, the patient is given
the first injection of the long-acting antibiotic extencillin – after
it is no longer contagious.
Treatment with bicillin or penicillin does not
quick effect and the person continues to pose a danger to the genital
partners before the end of the course of treatment with bicillin. If you are allergic to penicillin
treatment with second-line drugs, such as tetracyclines, is possible.
- What if
accidental unprotected intercourse occurred
Specific antibodies for syphilis and HIV appear in the blood
3 to 4 weeks after infection. But you should see a doctor after 1
week after suspicious sexual contact. No medication before treatment
cannot be taken to the doctor. The doctor will prescribe a special laboratory study “immunoblot”. It is highly specific and
highly sensitive method to detect traces of emerging antibodies
to the causative agent of syphilis.
For patients who have had syphilis in the past, it is important
understand the difference between the total analysis for immunoglobulins M and G and their determination in the blood separately.
Their summary analysis
will always be positive, because immunoglobulin G persists in the blood of previously ill
syphilis. Only immunoglobulin M indicates a new infection. This is a rather complicated question,
You don’t need to solve it on your own using the internet.
After suspicious unprotected intercourse
be sure to take a blood test for syphilis, an HIV test (it is also not taken
earlier than 3-4 weeks after exposure) and hepatitis C, which is easily
transmitted sexually. At the same time, a scraping is taken from the urethra or from
vagina and cervix for markers of diseases transmitted predominantly
sexually. Their pathogens include gonococcus, trichomonas, ureaplasma,
metaplasma, chlamydia, candida, gardnerella. The only correct approach
suspicious unprotected sexual intercourse – pass the entire set of tests.
- How to protect yourself from
sexually transmitted diseases
A good condom guarantees protection against STDs while
provided that it is correctly put on, that it has not burst, that the extragenital
contacts – oral and anal – were also carried out in a condom.
On
Today there is no better protection against STDs than a condom. Genital processing
organs drugs such as miramistin is not effective!
Karzanov Oleg Valerievich
Dermatovenerologist
Candidate of Medical Sciences.
Gosteva Irina Valerievna
Dermatovenerologist
Candidate of Medical Sciences.
Clinical efficacy of ceftriaxone in the treatment of early forms of syphilis
Different periods in the development of syphilidology are associated with certain priorities of scientific research. However, like decades ago, the improvement of specific therapy for syphilis remains relevant [1—3]. The expansion of the arsenal of antisyphilitic drugs, the search for effective antibiotics in the treatment of syphilis, along with the tendency to shorten the duration and frequency of drug administration, are of particular relevance in the current situation of high incidence of this infection [4, 5]. Today, the WHO requirements for the effectiveness of the treatment of infectious diseases are 95%.
In recent years, the attention of syphilidologists has been attracted by ceftriaxone, a semi-synthetic third-generation cephalosporin antibiotic with high treponemicidal activity [6, 7]. The effectiveness of ceftriaxone is due to its ability to suppress the synthesis of the cell wall of the microorganism, inhibiting the synthesis of mucopeptides. This drug is resistant to the action of beta-lactamases (penicillinase and cephalosporinase) Treponema pallidum. The main difference between ceftriaxone and other third-generation cephalosporins is its bioavailability — 100% and a high half-life, which allows the drug to be used once a day [8].
The first serious domestic study of the effectiveness of ceftriaxone in the treatment of primary and secondary syphilis was carried out at the Central Dermatovenerological Institute V.A. Akovbyan and A.A. Kubanov in 1996-1998. [9, 10], which then made it possible to include ceftriaxone in the domestic “Guidelines” for the treatment and prevention of syphilis (1999).
Further research by O.M. Yushchenko [7], O.K. Losev et al. [8] led to the inclusion of this drug in the 2007 Clinical Guidelines [11]. However, in these documents, the recommended doses and duration of treatment are somewhat different. So, in the “Methodological recommendations” for secondary and early latent syphilis, it is recommended to 0.5 g intramuscularly 1 time per day, daily for 10 days, and in the “Clinical recommendations” – 1.0 g intramuscularly 1 time per day for 20 days.
This work pursued the following objectives:
– to establish the effectiveness of ceftriaxone in primary, secondary and early latent syphilis in patients treated at the Republican Dermatovenerological Dispensary of the city of Izhevsk;
– to give a comparative description of the effectiveness of the treatment of syphilis with ceftraksone and penicillin preparations.
Material and methods
We analyzed the effectiveness of treatment with ceftriaxone in 100 patients (57 women and 43 men aged 15 to 70 years) who were treated in the RKVD in 2005-2008.
Employed persons accounted for 62%, the unemployed – 28%, students of various educational institutions – 8%, non-working pensioners – 2%.
Primary syphilis suffered from 5% of patients (4 men and 1 woman), secondary – 61% (25 men and 36 women), early latent – 34% (20 women and 14 men). Among patients with secondary syphilis, 11% had residual manifestations of the primary period (epithelizing chancre, inguinal lymphadenitis). In the remaining patients, the clinical picture corresponded to the diagnosis of secondary syphilis: trunk roseola was observed in 56% of patients; papules of the trunk – in 16%; papules of the palms – in 36%; papules of the soles – in 39%; erosive papules of the oral cavity were noted in 31%. Specific erythematous angina was noted in 31% of patients; papules of the tongue – in 18%, specific laryngitis – in 13%; erosive papules of the genitals and perianal area – in 34%. 5% of patients had later manifestations of secondary syphilis – alopecia and wide condylomas.
According to our observations, as well as according to domestic and foreign authors [3, 7, 12], the most common manifestation of secondary syphilis was roseola, and the rarest manifestations were warts alopecia and alopecia.
Most patients (72%) received treatment in a day hospital, the rest were treated on an outpatient basis. All of them were examined by specialists: therapist, ophthalmologist, neurologist. The treatment was carried out according to the following method: ceftriaxone 0.5 g daily intramuscularly for 10 days, 1 time per day. Tolerability of treatment with ceftriaxone was good, there were no cases of allergic reactions. The results of treatment were assessed by the timing of regression of syphilides and negative serological reactions, the frequency of clinical relapses, serorelapses, and seroresistance.
Results and discussion
The following results of the timing of regression of syphilides were obtained. Roseola of the trunk disappeared on the 3rd-20th day from the start of treatment; papules of the trunk – on the 7-20th day; papules of the palms and soles – on the 5th-20th day; erosive papules of the oral cavity and tongue – on the 5th-14th day; erosive papules of the genitals and perianal area regressed on the 5th-17th day; wide warts – on the 10-21st day.
The terms of regression of syphilides in patients with secondary syphilis are presented in Table. 1
According to O.M. Yushchenko [7], trunk roseola regressed 7 days after the start of treatment; papules of the body – after 11 days; papules of the palms and soles – after 13 days; erosive papules of the oral cavity and tongue – after 6 days; erosive papules of the genitals and perianal area regressed within 8 days; wide warts persisted for an average of 17 days.
According to A.T. Abishev [12], the regression of syphilides occurred in the following periods: roseola – on average 6 days, papules of the palms and soles – 13 days, wide condylomas – 8 days, papules on the oral mucosa – 5 days. It should be noted that the author in in his work indicates that ceftriaxone of the company F. Hoffman-La Roche, rocephin, was used to treat patients.
The results of the effectiveness of treatment were also evaluated according to the data of clinical and serological observation of patients for 12 months or more after completion of treatment.
The study of serological reactions was carried out 1 time in 3 months. The results of clinical and serological observation after treatment of patients with ceftriaxone are presented in Table. 2.
As can be seen from the table. 2, in 4 out of 5 patients with primary syphilis, negative serological reactions occurred within six months. In 67.2% of patients with secondary and in 23.5% of patients with early latent syphilis, persistent negative serological reactions were noted within 24 months. Delayed negative serological reactions were present in 23.7% secondary and 59%4% of patients with early latent syphilis treated with ceftriaxone. The proportion of adverse outcomes (clinical and serological relapses, seroresistance) was 6.4% in secondary and 14.7% in early latent syphilis. In persons treated for secondary syphilis, relapses of the disease prevailed, and in those treated for latent syphilis, seroresistance prevailed. It should be noted that all three cases of recurrence of the disease after treatment for secondary syphilis occurred in patients with late manifestations (alopecia, wide condylomas).
Our data are close to those of O.M. Yushchenko [7], who also noted a slowdown in the negativity of seroreactions in 30% of patients with secondary and almost 60% of early latent syphilis, as well as treatment failures in 7%. At the same time, A.T. Abishev [12] observed complete negative serological reactions within 5 months in all patients with secondary and early latent syphilis treated with rocefin. A comparative analysis of the effectiveness of treatment of patients with early forms of syphilis with ceftriaxone and penicillin preparations [2] also showed the comparability of treatment results, although, undoubtedly, more favorable results were observed in the treatment with water-soluble penicillin (Table 3).
More often failures (seroresistance, serological and clinical relapses) were observed in patients with early latent and secondary syphilis with “late” manifestations both in the treatment with ceftriaxone and penicillin drugs.
Discussion and conclusions
Thus, based on the data obtained from the analysis of the results of treatment of 100 patients with early forms of syphilis treated with ceftriaxone, and taking into account a comparative analysis of literature data in recent years, the following conclusions can be drawn.
The regression of the clinical manifestations of syphilis is somewhat slower compared to similar data from other researchers; delayed negative serological reactions occurred in every third patient with secondary and more than half of patients with early latent syphilis treated with ceftriaxone. Treatment failures (clinical and serological relapses, seroresistance) were observed in 6.4% of patients with secondary syphilis and 14.7% with early latent syphilis, which is comparable to literature data and our own observations regarding penicillin drugs. Patients with secondary syphilis were more likely to relapse, and those treated for latent syphilis were more resistant to seroresistant. The drug is well tolerated (not a single case of poor tolerance has been recorded).
Since the pharmacokinetic provision of the ceftriaxone treatment method is more than satisfactory [8], it can be assumed that the lack of efficacy is due to the short duration of treatment and insufficient single dose, inadequate for such forms of syphilis as secondary and early latent.