- Test for penicillin allergy
- How penicillin desensitization is done
- Common reactions of penicillin
- When penicillin is contraindicated
The most effective remedy to treat syphilis is benzathine penicillin, which must always be administered as an injection and the dose varies depending on the stage of the disease.
In case of allergy to this medication, other antibiotics such as tetracycline, erythromycin or ceftriaxone may be used, but penicillin is the most effective medication and is always the first choice. Before testing another antibiotic, one should opt for penicillin desensitization so that treatment can be done with this same medication. Desensitization consists of applying small doses of penicillin until the body can not reject this medication.
The treatment schedule should be done according to the doctor's guidelines but they can be:
| Disease stage | Penicillin dose | Other medicines |
| Primary syphilis | 1 injection of benzathine penicillin of 2, 400, 000UI. |
Doxycycline, 100 mg 2x / day or Tetracycline, 500 mg 4x / day or both for 14 days |
| Secondary syphilis |
2 injections of 1, 200, 000 IU benzathine penicillin in two different locations on the body. |
Doxycycline, 100 mg 2x / day or
Tetracycline, 500 mg 4x / day or both for 14 days |
| Tertiary syphilis | 3 penicillin injections with 2, 400, 000 IU in different locations on the body, with an interval of 7 days each dose | Doxycycline, 100 mg 2x / day or
tetracycline, 500 mg 4x / day, both for 28 days |
| Neurosyphilis | 6 daily injections of Penicillin G Crystalline with 2 to 4 million for 10-14 days | Procaine penicillin, 2.4 million
UI / IM / day, + Probenecid 500 mg / VO / 4x / day or both for 14 days |
| Congenital syphilis |
Crystalline Penicillin G 100 to 150 thousand IU / kg / EV / day, in 2 doses in the first week of life or in 3 doses for babies between 7 and 10 days; or Penicillin G Procaine 50 thousand IU / kg / IM, once a day for 10 days; or Benzathine Penicillin G ** 50 thousand IU / kg / IM, Single dose |
Not indicated |
| Syphilis in pregnancy | Benzathine Penicillin G | Erythromycin Stearate 500
mg VO, 6/6 hours for 10 days or even the cure |
Test for penicillin allergy
The test to know if the person is allergic to penicillin consists of rubbing a small amount of this medication on the skin and observing if the place shows any signs of reaction such as redness or itching. If these signs are present the person is allergic.
This test must be performed by a nurse in a hospital environment and is usually done on the skin of the forearm.
How penicillin desensitization is done
Desensitization to penicillin is indicated in case of allergy to this medication, especially in case of treatment for syphilis during pregnancy and treatment for neurosyphilis. This removal of sensitivity in relation to penicillin should be done at the hospital, and the use of pills is the safest way.
There is no indication for the use of antihistamines or steroids before taking penicillin because these drugs do not prevent the anaphylactic reaction and can mask its first signs by delaying treatment.
Immediately after the procedure, treatment with penicillin should be started. If the person passes more than 28 days without having any contact with this medication, if necessary check again for signs of allergy and if they are present, desensitization must be started again.
Common reactions of penicillin
After the injection, symptoms such as fever, chills, headache, pain in the muscles and joints can appear, which can appear between 4 to 24 hours after the injection. To control these symptoms the doctor may recommend taking an analgesic or antipyretic.
When penicillin is contraindicated
Treatment for syphilis cannot be done with penicillin in case of Stevens-Johnson syndrome, toxic epidermal necrolysis and exfoliative dermatitis. In these cases, treatment for syphilis should be carried out with other antibiotics.
Also watch the following video and find out what the disease consists of:
