Treatment, Prevention and Control - Treponema pallidum Infections

Treatment

Penicillin is the drug of choice for treatment of all the stages of syphilis. A single intramuscular dose of benzathine penicillin G (50,000 units/kg, not to exceed 2.4 million units) is effective for treatment of primary, secondary, and early latent syphilis. No reports of T. pallidum showing resistance to penicillin have been documented. Doxycycline or tetracycline may be used for non-pregnant patients allergic to penicillin. Jarish-Herxheimer reac-tion is a noted complication observed following therapy withantibiotics. It is characterized by chills, rigors, and increase in temperature, decrease in blood pressure, and tachycardia. This reaction occurs due to production of endotoxin and other toxic products released following rapid killing and lysis of the bacteria.

Prevention and Control

Avoidance of sexual contact with infected partners avoids trans-mission of infection. Use of condoms during sexual intercourse or antiseptics (such as potassium permanganate) or prophylac-tic use of antibiotics may minimize the risk of transmission of the disease. The use of penicillin prophylaxis, however, carries the danger that it may suppress the primary lesion without eliminating the infection.