Syphilis Treatment. Prices, Reviews, Ratings
The Need for Syphilis Treatment
According to WHO data, syphilis remains one of the most socially significant diseases today. Compared to the mid-90s, when syphilis incidence peaked, the number of cases has significantly decreased. However, many patients conceal their syphilis diagnosis, attempting self-treatment or relying on unofficial medicine. This leads to an increase in advanced cases, particularly neurosyphilis.
It is characterized by irreversible changes in the central nervous system and is untreatable.
The incidence of congenital syphilis has slightly decreased, reflecting the coordinated efforts of women’s health clinics and venereologists, timely diagnostics, and properly conducted preventive treatment for pregnant women.
Stages of Syphilis Treatment
Preparation
Treatment begins only after a comprehensive patient examination. This is necessary to confirm the diagnosis and identify the disease stage.
The diagnostic algorithm for syphilis includes the following steps:
- patient examination and history collection;
- laboratory testing;
- instrumental examination.
During history collection, the doctor thoroughly questions the patient about their symptoms, determining their onset and likely cause together. The number of sexual partners is also established. During the examination, special attention is paid to the condition of the skin, mucous membranes, genitals, and lymph nodes, noting changes characteristic of syphilis.
Laboratory testing confirms the presence of treponemes in chancre contents, syphilides, or gummas using dark-field microscopy, direct immunofluorescence, or polymerase chain reaction (PCR). Various serological tests are also conducted to detect antibodies to the syphilis causative agent.
Instrumental methods such as X-rays, ultrasound, CT, or MRI are used as needed to assess damage to internal structures.
In the early stages, syphilis treatment may take about two to three months. In later stages, it can last 1.5–2 years, followed by a prolonged prevention period.
Treatment Procedure
The primary drug group for syphilis treatment is antibiotics, administered either in courses or continuously. Dosage and duration are determined individually based on the syphilis stage, patient’s body weight, comorbidities, and drug tolerance. Supportive therapies may include immune boosters, vitamins, hepatoprotectors, and probiotics. Commonly used antibiotic groups include:
- penicillins;
- cephalosporins;
- macrolides.
Treponema pallidum is one of the few microorganisms that retains sensitivity to penicillin-class drugs, lacking enzymes to break down penicillin and not mutating its proteins to adapt to antibacterials. Penicillins are most effective for treating:
- primary syphilis;
- congenital syphilis;
- neurosyphilis without irreversible changes;
- tertiary syphilis, after preliminary treatment with tetracyclines or macrolides.
Syphilis treatment with simple penicillin injections has proven highly effective. The daily dose is divided into eight administrations, with a three-hour interval between each. Previously, an initial high-dose antibiotic “shock” was used, but this approach is now outdated. Macrolides and cephalosporins are rarely used, primarily in cases of penicillin intolerance.
Among macrolides, erythromycin is most commonly used. Recently, azithromycin, a newer macrolide, has shown efficacy against Treponema pallidum, though it is contraindicated in HIV-positive patients.
Among cephalosporins, ceftriaxone (a third-generation cephalosporin) is used for syphilis treatment. It is suitable for pregnant women, secondary and tertiary syphilis, latent syphilis, and central nervous system involvement, but not recommended for congenital syphilis (this also applies to azithromycin).
Hepatoprotectors help the liver cope with increased stress, while probiotics restore normal gut flora, reducing the risk of side effects like dysbiosis. Immune-boosting drugs and vitamin complexes are prescribed during rehabilitation.
Rehabilitation Period
Medical rehabilitation is indicated for patients with early syphilis and delayed seronegativity of the complement fixation test. Its goal is to enhance the body’s defenses using laser irradiation of peripheral lymph nodes, injections of thymalin, thymogen, retabolil, and vitamin-mineral complexes, alongside physiotherapy such as microwave therapy, blood UV irradiation, and transcutaneous laser therapy.
For patients with late-stage syphilis and positive serological results, a rehabilitation program is developed collaboratively by a venereologist and related specialists.
Rehabilitation treatment using these methods is conducted 6–12 months after etiological treatment, with two to three monthly courses annually. Two years after primary treatment, sanatorium-resort therapy may be recommended.
Before removal from monitoring, a syphilis patient must undergo serological and, if indicated, clinical examinations. Syphilis is considered cured if:
- treatment was complete and followed guidelines;
- clinical signs are absent;
- serological tests are negative.
Children with treated acquired syphilis may attend daycare or school once clinical signs disappear.
Indications
Syphilis treatment is necessary in the following cases:
- presence of symptoms confirmed by diagnostic tests;
- sexual contact with a syphilis-infected partner;
- incorrect treatment course (complete absence or improper regimen).
Pregnant women with a history of syphilis receive preventive treatment at 22–25 weeks, repeated in subsequent pregnancies.
Contraindications
Treatment is not recommended in the presence of:
- severe non-syphilitic liver diseases;
- widespread acute inflammatory skin conditions;
- exacerbated peptic ulcer disease or acute gastrointestinal disorders;
- decompensated diabetes mellitus;
- hemoptysis or severe tuberculosis forms.
For penicillin intolerance, alternative drugs like cephalosporins or macrolides are used.
Possible Complications
Syphilis consequences are divided into early and late categories. Early complications (primary and secondary syphilis) include:
- penile gangrene;
- meningitis;
- neuritis of cranial nerves II and VIII;
- orchoepididymitis — inflammation of the testes and appendages;
- kidney and liver damage.
Late consequences vary by impact: fatal outcomes include aortic inflammation and aneurysm, pulmonary fibrosis, and bronchiectasis; disabling conditions include bone damage like saddle nose or palate perforation. Late syphilis affecting the central nervous system causes deafness, vision issues, tabes dorsalis, and progressive paralysis.
In pregnant women, syphilis can lead to miscarriage, preterm birth, or antenatal fetal death. Early congenital syphilis may cause newborn mortality, while late congenital syphilis results in disability and early death.
Prices and Clinics
Syphilis diagnosis and treatment are performed by qualified, experienced venereologists. On the medical online resource, you can find a suitable medical center and specialist and book an appointment.
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