Syphilis Treatment Guidelines
Before the introduction of penicillin, the heavy-metal cure often caused thousands of deaths each year. The morbidity and mortality of the disease itself was horrendous, involving all ages from the fetus to the elderly - Richard Arnold MD
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HWN Suggests
Syphilis – Its early history and Treatment until Penicillin and the Debate on its Origins
In 1943 penicillin was introduced as a treatment for syphilis by John Mahoney, Richard Arnold and AD Harris. [22] Mahoney and his colleagues at the US Marine Hospital, Staten Island, treated four patients with primary syphilis chancres with intramuscular injections of penicillin four-hourly for eight days for a total of 1,200,000 units by which time the syphilis had been cured. This became a turning point in the treatment for syphilis as penicillin was shown to be highly effective when administered during either its primary or secondary stages, and it had few side effects of any significance when compared to mercury or arsenic.
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Recommended Regimen for Primary and Secondary Syphilis* Among Adults
Benzathine penicillin G 2.4 million units IM in a single dose.
Recommended Regimen for Syphilis Among Infants and Children
Benzathine penicillin G 50,000 units/kg body weight IM, up to the adult dose of 2.4 million units in a single dose.
Clinical Reminders during Bicillin L-A® Shortage
Prioritize using Bicillin L-A® to treat pregnant people with syphilis and babies with congenital syphilis – penicillin is the only recommended treatment for these populations.
Articles of Interest
Alternative Treatments for Syphilis During Pregnancy
The success of benzathine penicillin G treatment is as high as 98.2% in the prevention of congenital syphilis. In nonpregnant patients, doxycycline and ceftriaxone8 are accepted alternative treatments; however, benzathine penicillin G is the only recommended treatment for syphilis in pregnancy.
Resources
CDC
A single injection of long-acting Benzathine penicillin G can cure the early stages of syphilis. This includes primary, secondary, or early latent syphilis. CDC recommends three doses of long-acting Benzathine penicillin G at weekly intervals for late latent syphilis or latent syphilis of unknown duration. Treatment will cure the infection and prevent further damage, but it will not repair damage already done.
Canada.ca
A single injection of long-acting Benzathine penicillin G can cure the early stages of syphilis. This includes primary, secondary, or early latent syphilis. CDC recommends three doses of long-acting Benzathine penicillin G at weekly intervals for late latent syphilis or latent syphilis of unknown duration. Treatment will cure the infection and prevent further damage, but it will not repair damage already done.
