Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation Treatment questions for doctor specialist Home Care warning signs Prevention Outlook Complications Underlying Cause Transmission

Syphilis Treatment

Treatment for syphilis includes antibiotics and acetaminophen or nonsteroidal anti-inflammatory medications for pain and fever. Penicillin is considered to be the treatment of choice for treating syphilis. The CDC recommends that those who are allergic to penicillin undergo penicillin allergy skin testing and desensitization (followed by treatment with penicillin).

The penicillin dosing and schedule differs with the stage of the disease. Primary and secondary stage syphilis can be treated with a single dose of benzathine penicillin G (2.4 million units IM). Later stages require multiple doses delivered over weeks.

Treatment for syphilis includes:

Jarisch-Herxheimer Reaction
A known complication of antibiotic therapy is the Jarisch-Herxheimer reaction. This is represented by the onset of muscle aches, fever, headache, and a rapid pulse. The rash or chancre may even appear to worsen. The Jarisch-Herxheimer reaction is due to an inflammatory molecule that is released by the dying treponemes (syphilis bacteria). The reaction commonly develops within several hours of antibiotic dosing, but usually clears within 24 hours of onset.

Syphilis Questions For Doctor

The following are some important questions to ask before and after the treatment of syphilis.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • Am I contagious?
    • For how long?
  • What are the complications I should watch for?
  • How do I avoid passing the infection to others?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • What else can I do to reduce my risk for getting syphilis again?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Syphilis Specialist

Physicians from the following specialties evaluate and treat syphilis:

Continue to Syphilis Home Care

Last Updated: Jun 13, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Syphilis References
  1. Brown DL, Frank JE.Diagnosis and management of syphilis. Am Fam Physician. 2003 Jul 15;68(2):283-90. [12892348]
  2. Chan EL, Kingston MA, Carlin EM. The laboratory diagnosis of gonorrhoea and syphilis infection. J Fam Plann Reprod Health Care. 2004 Apr;30(2):126-7. [15087003]
  3. Lambert NL, Fisher M, Imrie J, Watson R, Mercer CH, Parry JV, Phillips A, Iversen A, Perry N, Dean GL. Community based syphilis screening: feasibility, acceptability, and effectiveness in case finding. Sex Transm Infect. 2005 Jun;81(3):213-216. [15923287]
  4. Singh AE, Romanowski B.Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clin Microbiol Rev. 1999 Apr;12(2):187-209. [10194456]
  5. Zeltser R, Kurban AK. Syphilis. Clin Dermatol. 2004 Nov-Dec;22(6):461-8. [15596316]
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