What kind of penicillin is used to treat syphilis

If you have had sex with someone within 90 days of their syphilis diagnosis, you would be presumptively treated even if your own syphilis test is negative. You would need to abstain from sex until the syphilis sores chancres are completely healed. Persons with vaginas or those who were exposed through anal sex may need a medical examination, as the sores may be internal and not readily seen.

Follow-up testing is used to ensure that the treatment worked. Syphilis antibody levels will be elevated after treatment, and they will gradually subside over time. A four-fold decrease in antibodies after one year is considered a treatment success. Most people are advised to undergo retesting six to 12 months after the completion of treatment. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Centers for Disease Control and Prevention.

Last reviewed April 13, Centers of Disease Control and Prevention. Updated July 22, Syphilis During Pregnancy. Stamm LV. Syphilis: antibiotic treatment and resistance.

Epidemiol Infect. Sexually transmitted infections treatment guidelines July 22, Tipple C, Taylor GP. Syphilis testing, typing, and treatment follow-up: a new era for an old disease.

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Cheng, Anne M. Doxycycline is the preferred recommended second-line agent for the treatment of syphilis, although efficacy data from controlled trials are lacking. We compared the serological responses of patients with early syphilis treated with doxycycline with the responses of patients treated with benzathine penicillin G BPG.

All patients who received a diagnosis of early syphilis attending 2 public sexually transmitted disease clinics in Baltimore, Maryland, who were treated with doxycycline mg orally, twice daily for 14 days between October and June were eligible. Patients treated with BPG a single dose of 2. Inclusion criteria included a clinician-recorded diagnosis of primary, secondary, or early latent syphilis with reactive serological test results at the time of diagnosis and at least 1 follow-up serological test titer.

Serological failure was defined as lack of a 4-fold drop in rapid plasma reagin titer — days after treatment, or a 4-fold increase in titer 30— days after therapy. During the study period, patients were treated for early syphilis, and 87 received doxycycline. Of those treated with doxycycline, 34 met the inclusion criteria. Seventy-three patients from a randomly selected group of age-matched individuals treated with BPG met the inclusion criteria.

There were 4 patients with serological failure in the BPG group 5. Doxycycline appears to be an effective agent for the treatment of early syphilis. In the United States, benzathine penicillin G BPG is the recommended first-line agent for the treatment of early syphilis in the primary, secondary, and early latent stages [ 1 ].

Doxycycline, ceftriaxone, and azithromycin are recommended as alternate agents in nonpregnant patients unable to tolerate treatment with BPG. In patients with a severe penicillin allergy, it may not be feasible to use ceftriaxone. Recently, an increased number of azithromycin-resistant syphilis cases have been reported from certain areas with high rates of azithromycin use [ 2 , 3 ]. Doxycycline mg orally twice daily for 14 days is endorsed as an alternative preferred therapy, despite a paucity of efficacy data.

In the late s, data on the successful use of the tetracycline derivatives chlortetracycline Aureomycin, Wyeth and oxytetracycline Terramycin, Pfizer for the treatment of syphilis were published [ 4 , 5 ]. The tetracyclines were an effective alternate class of antitreponemal agents [ 6 ].

In , the successful use of tetracycline 2 g orally for 12 days in 4 patients with early syphilis was reported [ 7 ]. The introduction of doxycycline, a tetracycline derivative with better oral bioavailability and fewer side effects, resulted in growing interest in its use for the treatment of syphilis. However, there have been no controlled trials to evaluate the effectiveness of doxycycline. In an uncontrolled observational study in , Onoda [ 8 ] evaluated the therapeutic effects of doxycycline mg orally twice daily for 28 days, repeated 2—4 times during the course of the year on the serological responses of patients with syphilis.

In another uncontrolled study by Harshan and Jayakumar [ 9 ], 40 patients with early syphilis were treated with doxycycline mg orally per day for 10—15 days.

All 20 patients who completed the therapeutic course responded to treatment, and none experienced relapse during the 9-month follow-up period. We conducted a retrospective case-control study to compare the serological response rates of patients with early syphilis treated with the CDC-recommended doses of BPG and doxycycline. Study setting. We conducted a record-based retrospective study. Data collection and definitions. Primary, secondary, and early latent syphilis diagnoses were made by trained clinicians at the sexually transmitted disease clinics on the basis of current CDC criteria [ 10 ].

Patients were screened with the nontreponemal Rapid Plasma Reagin test; patients whose specimens had a serological reaction were then confirmed to have syphilis with the Fluorescent Treponemal Antibody Absorption test. Patients with primary syphilis whose serological test results were nonreactive at the time of treatment were excluded, because this study focused on serological responses. Information about demographic characteristics, the reason for visiting the clinic, patient and sexual partner behavioral risks, the stage of syphilis, and treatment were collected using a standardized clinical encounter form.

Clinicians entered clinical data; the form was scanned into a clinic database and then linked to laboratory results obtained for specimens collected that day.

All diagnostic, screening, and data entry procedures were standard clinic practice. Any data from follow-up visits to either of the sexually transmitted disease clinics were also captured. To capture all available follow-up serological test results, we obtained serological test results from a statewide syphilis registry that included results from public and private testing venues throughout the state of Maryland.

All patients attending the 2 Baltimore sexually transmitted disease clinics between and who were diagnosed and treated for early syphilis were eligible. Therapy consisted of doxycycline mg orally twice daily for 14 days or BPG a single, intramuscular 2.

To be included in the study, at least 2 serological titers an initial titer at the time of treatment and at least 1 follow-up titer — days after the date of treatment were necessary. Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis.

Combinations of some penicillin preparations e. Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

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Another option for notifying partners about possible STD exposure is through an online tool that delivers a message — either including your email address or anonymously — to the email addresses you specify.

Sources Syphilis. Mayo Clinic. January 10, Centers for Disease Control and Prevention. June 13, Syphilis Treatment and Care. November 30, Partner Services. February 17, By subscribing you agree to the Terms of Use and Privacy Policy.