Antibiotic regimen helps the patients to defy the fatal consequences of syphilis. Syphilis is a highly contagious disease caused by a bacterium known as Treponema pallidum. Being a venereal disease, it progresses through different stages with the last one resulting in possible fatality.
However, since the emergence of the antibiotic penicillin, a syphilitic patient can get relief within the primary stages of infection. Penicillin is regarded as the treatment of choice, as prescribed regimen of the said antibiotics found to have the required efficacy against syphilis. During the primary stage of syphilis, one time dose of penicillin has proven to be effective.
Generally a single dose of Benzathine penicillin G is recommended for patients with primary or secondary stages syphilis. The antibiotic is injected intramuscularly into the patient. Nevertheless, patients with much progressed late latent stage, the doses levels are increased.
In such a case, 3 doses of Benzathine penicillin G are given with an interval of one week in between. In patients with history of penicillin allergies, skin tests are done. People with positive skin tests, desensitization are carried out before applying the treatment.
Penicillin is the only recommended treatment in case of pregnant individuals. However, studies have shown, recommended regimens for the prevention of congenital syphilis and treatment of maternal infection are effective, but the highest risk of fetal treatment failure exists with maternal secondary syphilis.
In patients with neurosyphilis, much more elaborate regimen is prescribed. Patients are given aqueous crystalline penicillin G through intravenous method after every 4 hours for a period of 10 to 14 days. Due to slowly dividing bacteria, most experts now recommend 3 weekly doses of benzathine penicillin G after the given initial treatment.
Treatment Options For Syphilis
Alternatives To Penicillin
Though being not established due to few number of studies, many other antibiotics are found to be effective in treatment of syphilis. Antibiotics such as Tetracycline, erythromycin, and ceftriaxone are being used in patients allergic to penicillin. Radomized clinical trials have concluded Azithromycin to be a good alternative as well. But due to studies suggesting emergence of resistance in bacteria against azithromycin, it is mainly recommended if penicillin G is found to be non-applicable.
In case of late latent stage of syphilis, tetracycline or doxycycline is employed in case of penicillin allergy. The doses however for given antibiotics in increased to 28 days as opposed to normal 14 days.
Though painful, use of procaine penicillin administered with probenecid presents an alternative to penicillin in patients with neurosyphilis. The treatment extends to a period of two weeks.
Patients with neurosyphilis are also treated with anti-psychotic medications to control psychological problems arising due to infection.
Patient undergoing treatment for syphilis, often face side effects such as myalgias, fever, headache, and tachycardia. Usually disappearing after 24 hours, these reactions are result of cytokine attack on cell fragments released by dying bacteria. Doctors are usually responsible to caution the patients for any such distress.
Cardiovascular syphilis may prompt doctor to carry out surgery treating complication such as aortic valve failure. Regular regimen of antibiotics along with frequent blood assessments helps the patients to recover from syphilis and prevent any reoccurrence in later years.
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