Treatment for syphilis is generally done with injections of benzathine penicillin, also known as Benzetacil, which must be recommended by a general practitioner, infectious disease specialist or obstetrician-gynecologist, in the case of pregnant women diagnosed with syphilis. The treatment time, as well as the number of injections, may vary according to the stage of disease evolution and symptoms presented.
When the wound that does not bleed and does not hurt is still present, it is enough to take 1 dose of penicillin to cure syphilis, but when it comes to secondary or tertiary syphilis, up to 3 doses may be necessary.
The injections are applied to the gluteal region once a week, according to medical advice, however, when it comes to tertiary syphilis or neurosyphilis, hospitalization is necessary, as it is a more advanced disease and has other complications involved.
Therefore, according to the CDC and the Ministry of Health’s STI clinical protocol, treatment for syphilis in adults must be carried out following this plan:
After injecting penicillin, a reaction that causes fever, muscle pain, headache, rapid heartbeat, low breathing and a drop in blood pressure is common. These symptoms can persist for 12 to 24 hours and should only be treated with Paracetamol.
It is also important to carry out a syphilis test, the VDRL, regularly and in accordance with the doctor’s instructions, which normally recommends every 3 months, as this makes it possible to assess whether the treatment is being effective and, if not, a new therapeutic regimen may be indicated. Understand better about the VDRL exam.
What to do if you are allergic to Penicillin?
In case of allergy to penicillin, desensitization to penicillin should be chosen because there are no other antibiotics capable of eliminating the allergy. Treponema pale. However, in some cases the doctor may prescribe doxycycline, tetracycline or ceftriaxone.
Treatment during pregnancy
Treatment for syphilis during pregnancy should only be done with antibiotics derived from Penicillin, such as Amoxicillin or Ampicillin, as other antibiotics can cause malformations in the fetus.
If the pregnant woman is allergic to Penicillin, the doctor may recommend treatment after pregnancy, if the disease is latent, or use Erythromycin in tablet form for 15 to 30 days, depending on the week of pregnancy. See more details about the treatment of syphilis during pregnancy.
Treatment for congenital syphilis
Congenital syphilis is that which appears in the baby and is transmitted from the infected mother. In these cases, treatment must be guided by the pediatrician and is normally started shortly after birth with Penicillin directly into the vein every 12 hours for the first 7 days of life.
When treatment for congenital syphilis begins, it is normal for some newborns to develop symptoms such as fever, rapid breathing or increased heart rate, which can be controlled with other medications such as Paracetamol. Find out more details about the treatment of congenital syphilis.
Care during treatment
During treatment, or immediately after the diagnosis of syphilis, the person must take certain precautions, such as:
- Inform your partner or partner to test for the disease and initiate treatment, if necessary;
- Avoid sexual contact during treatment, even with a condom;
- Get tested for HIVas infection by Treponema pale increases the risk of infection with the HIV virus.
Even after treatment, the patient may contract syphilis again and, therefore, it is important to continue using a condom during all intimate contact to avoid being reinfected with syphilis or other sexually transmitted diseases.
Signs of improvement and worsening
Signs of improvement in syphilis appear approximately 3 to 4 days after starting treatment and may include increased well-being, reduction in swelling and healing of wounds, for example.
On the other hand, when treatment is not carried out as prescribed by the doctor, it is possible to notice signs of worsening, such as fever above 38ºC, joint and muscle pain, decreased muscle strength and progressive paralysis. Furthermore, in these cases, there may also be a greater risk of developing complications, such as meningitis, hepatitis, joint deformity and paralysis, for example.
Check out the video below for more details about syphilis:
Bibliography
- MINISTRY OF HEALTH. Therapeutic regimen for syphilis and cure control. 2017. Available at: <https://saude.rs.gov.br/upload/arquivos/201703/16152016-4-5-7-esquema-tto-sifilis.pdf>. Accessed on May 9, 2022
- CDC. 2015 Sexually Transmitted Diseases Treatment Guidelines: Syphilis. Available at: <https://www.cdc.gov/std/tg2015/syphilis.htm>. Accessed on May 28, 2019
- Ministry of Health. Clinical Protocol and Therapeutic Guidelines (PCDT): Comprehensive Care for People with Sexually Transmitted Infections (STIs). 2nd ed. Brasília: 2015. 97-98.
