In nearly all cases, the standard syphilis treatment is the antibiotic penicillin, specifically benzylpenicillin or penicillin G as it is most often called. Parenteral penicillin, which means penicillin administered by injection or intravenously, is usually used instead of penicillin administered orally. Various dosages of penicillin G are used depending on the stage of the disease. Often, only one dose of penicillin is required to treat the early stages of syphilis. Patients who are highly allergic to penicillin may be given other antibiotics, such as tetracycline, but there is some concern about their effectiveness.
Penicillin used to treat diseases is derived from the Penicillium fungi. While several species of this fungi exist, Penicillium chrysogenum is the one used to treat bacterial infections such as syphilis. Besides syphilis treatment, penicillin is the standard antibiotic treatment for other sexually transmitted diseases such as gonorrhea and chlamydia.
Syphilis progresses in three stages: primary, secondary, and tertiary syphilis. Each stage is identified by the amount of time after initial contraction of the disease. Primary syphilis is generally occurs during the first month after contracting the disease, secondary occurs for the next two to six months, while tertiary syphilis sets in after six months. Patients who receive syphilis treatment in the early stages are less likely to have long-term effects.
Other categories of syphilis include latent syphilis, which has no outward indications of the disease, and neurosyphilis, which involves the infection of the central nervous system. Neurosyphilis is especially common in patients infected with the HIV virus. It's important that a stage must be identified when prescribing the correct dose of penicillin for syphilis treatment.
The standard treatment for primary, secondary, and early latent syphilis is a single dose of penicillin. Tertiary and late latent syphilis treatment usually involves weekly doses of penicillin administered for three weeks. Patients with neurosyphilis require more intensive treatment; penicillin is usually given intravenously for up to 14 days. HIV-positive patients who also test positive for syphilis have a higher rate of neurological complications and should be checked for these more frequently. After syphilis has been successfully treated, there is no danger of transmission of the disease.
It is important to note that syphilis treatment, especially in the secondary stage and with HIV patients, can cause side effects. Some patients suffer what is known as a Jarisch-Herxheimer reaction, which can occur when toxins are released by the bacteria as they die. Headache, fever, and muscle pain is common with this reaction, but usually go away after a few hours. This reaction can be treated with over-the-counter pain relievers.
