How Long Does Syphilis Treatment Take? Expert Advice on Recovery

How long does treatment for syphilis typically last?

Hello Doctor: On October 29th of this year, I tested positive for syphilis.
At that time, the doctor prescribed a single dose of eight tablets of Doxycycline for treatment.
However, a month later, on November 29th, I still had red rashes on my hands and feet that did not improve.
I received a dose of Penicillin, and while the condition of my feet has improved, I still have rashes on my hands.
I would like to ask if you recommend another dose of Penicillin, or should I wait three months to retest and then decide based on the results? Or do you have any other suggestions? Lastly, I would like to know if there are more effective treatment options for syphilis.
(I am really struggling with this condition and feeling very sad...)

coco, 20~29 year old female. Ask Date: 2018/12/10

Dr. Cai Zhuorong reply Urology

The treatment of syphilis depends on the duration of the infection, whether the patient is pregnant, and the presence of neurological symptoms.
According to the 2015 STD Treatment Guidelines from the CDC, early syphilis can be treated with a single intramuscular injection of benzathine penicillin G 2.4 million units.
After completing treatment for early syphilis, the VDRL titer should decrease fourfold within three months and eightfold within six to twelve months.
Rash on the hands and feet may resolve on its own within two years, even without treatment.
Syphilis poses significant risks but is not difficult to eradicate.
Historically, there have been various methods to treat syphilis; however, the most effective approach remains appropriate penicillin injections.
It is recommended that you return for follow-up care.
Wishing you a speedy recovery.

Reply Date: 2018/12/10

More Info

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. The treatment for syphilis typically involves antibiotics, with penicillin being the most effective and commonly used. The duration and effectiveness of treatment can vary depending on the stage of the infection and the individual’s response to the medication.

In your case, you mentioned that you were treated with a single dose of azithromycin (日舒錠) and later received a dose of penicillin. It is important to note that while azithromycin has been used in some cases, penicillin remains the gold standard for treating syphilis, particularly in its later stages. The treatment duration and the number of doses required can depend on several factors, including the stage of syphilis at diagnosis and whether there are any complications or co-infections.

If you are experiencing persistent symptoms, such as the red rashes on your hands, it is crucial to follow up with your healthcare provider. They may recommend additional treatment or further evaluation to determine if the syphilis infection has been adequately treated or if there are other underlying issues contributing to your symptoms. It is not uncommon for some individuals to experience lingering skin manifestations even after successful treatment of syphilis, but these should be monitored by a healthcare professional.

Regarding your question about whether to wait three months to re-evaluate your condition or to receive another dose of penicillin, this decision should be made in consultation with your healthcare provider. They may suggest a follow-up blood test to assess the effectiveness of the treatment and determine if further intervention is necessary. In general, follow-up testing is recommended at 6 and 12 months after treatment to ensure that the infection has been cleared.

As for alternative treatments, while there are various antibiotics that can be used to treat syphilis, penicillin remains the most effective option. There are no alternative therapies that have been proven to be more effective than penicillin for treating syphilis. It is essential to adhere to the treatment plan prescribed by your healthcare provider and to communicate any ongoing symptoms or concerns you may have.

In summary, if you are experiencing persistent symptoms after treatment for syphilis, it is essential to consult your healthcare provider for further evaluation and management. They can provide personalized recommendations based on your specific situation and ensure that you receive the most effective care. Remember that early diagnosis and treatment are crucial in managing syphilis and preventing complications, so maintaining open communication with your healthcare provider is key.

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