How is Syphilis Treated?

Question: How is Syphilis Treated?

Answer:

Syphilis is treated with parenteral penicillin. This means that the penicillin is either injected into the muscle or given intravenously. Oral penicillin has not been shown to be effective in treating syphilis.

The drug regimens below are taken from the the Centers for Disease Control 2006 STD treatment guidelines. Remember that only your doctor can say which treatment is right for you.

Recommended Regimen for Adults With Primary or Secondary Syphilis

Benzathine penicillin G 2.4 million units in a single intramuscular injection

Recommended Regimen for Adults with Early Latent Syphilis

Benzathine penicillin G 2.4 million units in a single intramuscular injection

Recommended Regimen for Adults with Late Latent Syphilis, Latent Syphilis of Unknown Duration, or Tertiary Syphilis

Benzathine penicillin G 7.2 million units total, administered as 3 intramuscular doses of 2.4 million units each at 1-week intervals

Recommended Regimen for Adults with Neurosyphilis or Syphilitic Eye Disease

Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units IV every 4 hours or continuous infusion, for 10-14 days

Alternative Regimen for Adults with Neurosyphilis or Syphilitic Eye Disease

Procaine penicillin 2.4 million units IM once daily
PLUS
Probenecid 500 mg orally four times a day, both for 10–14 days

Notes: HIV+ individuals with syphilis may require additional treatments.

Pregnant women with syphilis are normally treated with the same regimen as other adults.

If you have been diagnosed with syphilis, your sexual partners need to be treated as well. Depending on the stage of your syphilis, at the time of diagnosis, the number of sexual partners who need to be notified will vary. If you were diagnosed with

• Primary Syphilis – All partners you have had for up to 90 days before you started experiencing symptoms should be tested and treated.
• Secondary Syphilis – All partners you have had for up to 6 months before you started experiencing symptoms should be tested and treated.
• Early Latent Syphilis – All partners you have had for up to 1 year before you started experiencing symptoms should be tested and treated.

Since it can take up to 90 days for a person who has been exposed to syphilis to test positive, most doctors will treat any recent sexual partners as though they have been infected. For partners who were exposed more than 90 before the time of diagnosis, their doctor may or may not decide to screen them for the disease before treatment.