Treatment for Syphilis: Misused Medicines
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The most effective drug to treat syphilis is benzathine Penicillin G, which should always be administered as an injection and the dose varies according to the phase of the illness.
In case of allergy to this drug, other antibiotics such as tetracycline, erythromycin or ceftriaxone can be used, but penicillin is the most effective drug always with the first choice. Before trying another antibiotic, you should opt for penicillin desensitization so that the treatment can be successful with this same drug. The desensitization consists of applying small doses of penicillin until the body cannot refuse this medication.
The treatment schedule must be according to the doctor’s guidelines, but it can be:
| Phases of illness | dose of penicillin | other medicines |
| primary syphilis | 1 injection Benzathine Penicillin G of 2,400,000IU. |
Doxycycline, 100 mg twice a day or Tetracycline, 500 mg 4x/day or both for 14 days |
| secondary syphilis |
2 injections of 1,200,000 IU of Benzathine Penicillin G in different regions of the body. |
Doxycycline, 100 mg twice a day or Tetracycline, 500 mg 4x/day or both for 14 days |
| tertiary syphilis | 3 injections of penicillin with 2,400,000 IU in different regions of the body, with an interval of 7 days between each dose | Doxycycline, 100 mg twice a day or tetracycline, 500 mg 4x/day, both for 28 days |
| neurosyphilis | 6 daily injections of Penicillin G Crystalline with 2 to 4 million for 10-14 days | Procaine Penicillin, 2.4 million IU/IM/day, + Probenecid 500 mg/PO/4x/day or both for 14 days |
| Congenital syphilis |
Penicillin G Crystalline 100 to 150 thousand O |
not indicated |
| Syphilis in the embarazo | Penicillin G Benzathine | Erythromycin Stearate 500 mg orally, 6/6 hours for 10 days or until reaching the cure |
Try to find out if you are allergic to penicillin
The way to know if the person is allergic to penicillin is to float a small amount of this drug in the skin and observe if the region presents some reaction signal such as reddening or comession. If these signs are present, the person has an allergy.
This task must be carried out by a nurse in the hospital and is generally carried out on the forearm.
How to desensitize penicillin
Desensitization to penicillin is indicated in case of allergy to this drug, especially in case of treatment for syphilis in embarazo and treatment of neurosyphilis. This procedure must be carried out in the hospital, being the use of tablets in the most secure way.
There is no indication for the use of antihistamines or steroids before starting penicillin, since these drugs do not prevent the reaction of anaphylaxis and can better hide the first signs, delaying the treatment.
After the procedure, treatment with penicillin should be started. If the person spends more than 28 days without any contact with this medicine, it will be necessary to check again if there are signs of allergy and if they are present, the desensitization should be started again.
Common reactions to penicillin
After the injection, symptoms such as fever, chills, headache, pain in the muscles and in the joints can arise that can appear from 4 to 24 hours after the injection. To control these symptoms, the doctor may recommend taking an analgesic or an antipyretic.
When penicillin is contraindicated
The treatment for syphilis cannot be treated with penicillin in the case of Stevens-Johnson, toxic epidermal necrolysis and exfoliative dermatitis. In these cases, the treatment for syphilis must be carried out with other antibiotics.
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