- What to do in case of allergy to Penicillin?
- Treatment during pregnancy
- Treatment for congenital syphilis
- Care during treatment
- Signs of improvement in syphilis
- Signs of worsening syphilis
- Possible complications of syphilis
Treatment for syphilis is usually done with injections of benzathine penicillin, also known as benzetacil, which must be indicated by a doctor, usually the gynecologist, obstetrician or infectologist. The duration of treatment, as well as the number of injections, may vary according to the stage of the disease and the symptoms presented.
When the wound that doesn't bleed and doesn't hurt is still present, just take 1 dose of penicillin to cure syphilis, but when it comes to secondary or tertiary syphilis, up to 3 doses may be needed.
The injections are applied in the gluteal region once a week, according to medical advice, but when it comes to tertiary syphilis or neurosyphilis, hospitalization is necessary, because it is a more advanced disease and has other complications involved.
Thus, and according to the CDC and the clinical protocol of STIs of the Ministry of Health, the treatment for syphilis in adults must be done according to this plan:
| Disease stage | Recommended treatment | Alternative | Examination to confirm the cure |
| Primary and secondary syphilis | Single dose of Benzetacil (total of 2.4 million units) | Doxycycline 100 mg, twice daily for 15 days | VDRL at 3, 6 and 12 months |
| Recent latent syphilis | 1 single injection of Benzetacil (total of 2.4 million units) | Doxycycline 100 mg, twice daily for 15 days | VDRL at 3, 6, 12 and 24 months |
| Late latent syphilis | 1 injection of Benzetacil per week for 3 weeks (total of 7.2 million units) | Doxycycline 100 mg, twice daily for 30 days | VDRL at 3, 6, 12, 24, 36, 48 and 72 months |
| Tertiary syphilis | 1 injection of Benzetacil per week for 3 weeks (total of 7.2 million units) | Doxycycline 100 mg, twice daily for 30 days | VDRL at 3, 6, 12, 24, 36, 48 and 72 months |
| Neurosyphilis | Crystalline Penicillin injections for 14 days (18 to 24 million units per day) | Injection of ceftriaxone 2g for 10 to 14 days | VDRL at 3, 6, 12, 24, 36, 48 and 72 months |
After taking penicillin, a reaction that causes fever, muscle pain, headache, fast heartbeat, low breathing and pressure drop is common. These symptoms can last for 12 to 24 hours and should only be treated with Paracetamol.
What to do in case of allergy to Penicillin?
In case of allergy to penicillin, one should opt for desensitization to penicillin because there are no other antibiotics capable of eliminating treponema palladium . However, in some cases the doctor may prescribe doxycycline, tetracycline or ceftriaxone.
Treatment during pregnancy
Treatment for syphilis in pregnant women should only be done with antibiotics derived from Penicillin, such as Amoxicillin or Ampicillin, as the other antibiotics can cause malformations in the fetus.
If the pregnant woman is allergic to Penicillin, the doctor may recommend treatment after pregnancy, if the disease is latent or use Erythromycin in tablet form for 15 to 30 days, depending on the week of gestation.
See more details on the treatment of syphilis in pregnancy.
Treatment for congenital syphilis
Congenital syphilis is that which appears in the baby and is transmitted from the infected mother. In these cases, treatment should be guided by the pediatrician and, normally, it is started right after birth with Penicillin directly in the vein every 12 hours for the first 7 days of life.
With the start of treatment for congenital syphilis, it is normal for some newborns to develop symptoms such as fever, rapid breathing or increased heart rate, which can be controlled with other drugs such as paracetamol.
Find out more details about the treatment of congenital syphilis.
Care during treatment
During treatment, or shortly after the diagnosis of syphilis, the person must take some precautions such as:
- Inform your partner to do the disease test and start treatment, if necessary; Avoid sexual contact during treatment, even with condoms; Get tested for HIV, as there is a high risk of being infected.
Even after treatment, the patient can get syphilis again and, therefore, it is important to continue using condoms during all intimate contact to avoid being contaminated again with syphilis or other sexually transmitted diseases.
Signs of improvement in syphilis
The signs of improvement in syphilis appear about 3 to 4 days after the start of treatment and may include increased well-being, reduced water and wound healing, for example.
Signs of worsening syphilis
Signs of worsening syphilis are more common in patients who do not undergo treatment as directed by the doctor and include fever above 38ºC, joint and muscle pain, decreased muscle strength and progressive paralysis.
Possible complications of syphilis
Complications of syphilis arise mainly in patients with a weakened immune system with HIV or who do not receive adequate treatment, including meningitis, hepatitis, joint deformity and paralysis.
Watch the following video and understand better how this disease develops:
