Which antibiotic is more suitable for syphilis. What drugs and medications to treat syphilis? Late stages of syphilis

Syphilis is one of the infectious pathologies that are sexually transmitted. The disease is caused by pale treponema.

With the development of syphilis, the mucous membranes, internal organs, skin, musculoskeletal system and the human nervous system are affected.

Depending on the time elapsed since the onset of infection, it happens:

• primary(from the appearance of a hard chancre to the onset of a rash);
• secondary(characterized by the appearance of a rash of various forms on any part of the human body, this type of disease occurs if it was not possible to detect primary syphilis (hereinafter referred to as PS) in a timely manner);
• tertiary(this type of disease is accompanied by a whole complex of external and internal lesions that can masquerade as manifestations of other pathologies).

Each of the above stages is characterized by the presence of specific increasing symptoms. The tertiary stage has the greatest danger, associated with a high risk of death due to deep damage to the internal organs and meninges.

The latest version of the International Classification of Diseases (ICD-10) provides a detailed list of forms according to which a disease can be:

• congenital;
• early;
• late;
• not specified.

Antibiotics for syphilis

Long-acting penicillins, represented by Retarpen ® , Bicillin ® , Extencillin ® , have proven themselves well. Having an excellent antibacterial effect, which allows you to quickly cope with the infectious process, they can at the same time cause a serious allergic reaction.

Patients suffering from intolerance to penicillin drugs are prescribed alternative antibiotics belonging to the class:

• macrolides ("Erythromycin" ®);
• tetracyclines (their prominent representative is "" ®);
• third generation ciprofloxacins (Ceftriaxone ®).

Penicillin therapy

The most powerful antibiotics for syphilis, which have a detrimental effect on pale treponema, are penicillin preparations, represented by:

• benzylpenicillin sodium salt ® ;
• novocaine salt of penicillin ® ;
• procaine-benzylpenicillin ® ;
• bicillin-3 ® ;
• bicillin-5 ® ;
• benzathine benzylpenicillin ® .

All drugs from this list belong to the category of injectables diluted in novocaine and intended for intramuscular injection. The top three drugs on the list are most commonly used for early (especially latent) forms. For the treatment of secondary syphilis, bicillin-5 ® and procaine-benzylpenicillin ® are most often used.

Penicillin preparations, which are well tolerated and have few side effects (cases of antibiotic-associated diarrhea among them are quite rare), are indispensable for:

• early forms of neurosyphilis;
• congenital syphilis.

Penicillin therapy, used in relation to patients suffering from late forms of tertiary syphilis (hereinafter referred to as TS), is combined with a two-week course of taking erythromycin ® (macrolide) or tetracyclines.

Semi-synthetic analogs of penicillins, drugs ampicillin ® and oxacillin ® , can be used as alternative drugs for the implementation of penicillin therapy in patients.

The duration of the use of penicillins for syphilis, depending on the stage of the disease and the effectiveness of the antibiotic in each case, can range from two weeks to six months.

If the patient is allergic to penicillins, antibiotics of other groups are prescribed to him, and cephalosporins that can cause a cross-allergic reaction are excluded from this list.

Before the introduction of an antibiotic, an allergic test is performed.

Macrolides

Erythromycin ® for syphilis is one of the most popular drugs of the macrolide class.

This is what a package of erythromycin ® in 250 mg tablets might look like

Azithromycin ® is not used for syphilis.

Macrolide preparations:

• They have a bacteriostatic effect on pale treponema by disrupting the synthesis of its proteins, so the onset of a clinically pronounced effect does not occur as quickly as when using penicillins.
• Due to the peculiarities of pharmacokinetics, they almost do not penetrate the blood-brain barrier, therefore, they are not effective in case of syphilitic damage to the nervous system.

Options for therapeutic regimens:

• Therapy of the primary form of the disease: erythromycin ® is taken 4 times a day, 500 mg for fifteen days.
• With syphilis that has reached the secondary stage, the drug is taken in strict accordance with the above scheme; the dosage of erythromycin ® remains the same (4 times a day, 500 mg), only the duration of the therapeutic course increases: from 15 days to one month.

The use of tetracyclines

Tetracycline drugs (most often treated with tetracycline ® and doxycycline ®) are prescribed for patients who are allergic to drugs of the penicillin class.

Doxycycline ® and tetracycline for syphilis:

• Often cause nausea, vomiting, metallic taste in the mouth, provoke the occurrence of diarrhea. Patients with impaired liver function require additional monitoring of the level of liver enzymes.
• It cannot be used to treat children under the age of eight, since their action can adversely affect the process of laying permanent teeth, as well as their timely eruption.

Tetracycline treatment regimens for syphilis:

• For the primary form, a fifteen-day course of doxycycline ® (twice a day, 0.1 g) and tetracycline (four times a day, 0.5 g) are prescribed.
• For the secondary form, the same dosages of doxycycline ® and tetracycline are carried out, but already for thirty days.

Cephalosporins

The only remedy of this series, approved for the treatment of all forms (up to tertiary) of syphilis, is "" ®. It is also indicated for the implementation of alternative therapy (if it is impossible to use penicillin drugs), and for the implementation of repeated treatment.

Ceftriaxone ® has a number of advantages:

• has a bactericidal effect on the pathogen;
• well tolerated by patients;
• rarely causes diarrhea and gastrointestinal disorders;
• can be used for patients of any (including infant) age.

Treatment of syphilis with ceftriaxone ® diluted in novocaine is carried out by performing intramuscular injections:

• in the primary and secondary stages of the disease, one injection is given (containing 1-2 g of the drug for adults, for children the dose is calculated depending on the weight) for 10 days;
• with TS for two weeks, one injection containing 2 g of ceftriaxone ® is performed; after 14 days the course is repeated.

An absolute contraindication to the use of ceftriaxone ® is the patient's acute individual intolerance to penicillins due to the high likelihood of cross-reactions.

What antibiotics are most effective?

Treatment is often carried out with antibiotics in the form of tablets used at all stages of the infectious process.

The most effective of them are presented in this list:

V-penicillin ®

- an antibiotic of bactericidal action, consisting in inhibition (delay) of the synthesis of bacterial cell walls. Side effects, mainly consisting in the development of allergic reactions (skin itch, urticaria, hyperemia of the skin), are observed in 5% of patients. Some patients may develop fever, angioedema, increased tissue bleeding, and leukopenia. Contraindicated in case of intolerance to cephalosporins and penicillins.

Vibramycin ®

- a preparation of the tetracycline series, the bacteriostatic effect of which is provided by the active substance - doxycycline. Daily dosage of vibramycin ® - 300 mg; duration - 10 days. In case of insufficient success of therapy, the course may be repeated.

There are many antibiotics used for early forms of syphilis, among which penicillin occupies the first place. Due to the short period of action of the drug and the frequency of allergic reactions among patients, as well as due to the possibility of structural changes in the gluteal muscles, which can prevent the absorption of the antibiotic into the patient's body, doctors have to look for new drugs to destroy pale treponema.

One of these promising drugs is tetracycline, the form of which is tablets or capsules, which allows you to bypass the problem of muscle deformation and different degrees of absorption of drugs with a large number of injections. The most justified treatment of syphilis with tetracycline is in the initial stages of the primary and secondary occurrence of the disease. The drug is recommended to be taken 4 times a day, 1 tablet, dosage of 0.5 g, trying to adhere to equal time intervals between doses.

When treating syphilis with tetracycline, some pharmacological and chemical features of this drug should be taken into account. It is highly recommended not to drink it with milk or to combine it with agents that can reduce the acidity of gastric juice, which can lead to the formation of insoluble compounds with magnesium and calcium salts. Another important point during the treatment period is the need to avoid prolonged exposure to direct sunlight. Otherwise, side effects may appear in the form of a sharp increase in skin sensitivity to ultraviolet radiation. Also, tetracycline is not prescribed for young children under the age of eight, since the drug does not have the most beneficial effect on the bone tissue of the child. Pregnant women are not prescribed tetracycline drugs, but are replaced by others that do not cross the placenta and do not threaten the health of the baby.

In the primary uncomplicated form of syphilis, the drug is taken 4 times a day for 15-20 days, in the initial stages of the secondary - 20-25 days, and in some cases - within 40 days. Such dosages of tetracycline are quite strong, and in many cases successfully treat syphilis with timely access to a doctor. However, throughout the course of therapy, two conditions must be met:

• During the period of treatment of syphilis with tetracycline, you should not take breaks in receptions, otherwise the treponema virus may develop resistance to the antibiotic.
• Until a complete cure, it is necessary to refrain from sexual intercourse so as not to infect others with the disease.

What antibiotics are effective for inpatient and outpatient treatment of syphilis? This question is asked by everyone who accidentally suffered from this insidious disease. If the disease is not treated, the health of the human body is threatened by irreversible consequences. Fortunately, medicine has identified several groups of antibiotics for the treatment of syphilis, including its primary and secondary period. But in order for the disease to recede, the doctor and the patient must act in well-coordinated cooperation. The duty of the doctor is to correctly select the group of the drug, determine the timing of administration and dose, and the patient must strictly follow the recommendations of the specialist and strictly take the medicine according to an individually developed scheme.

Antibiotics for syphilis effectively eliminate its symptoms during therapy, as they destroy the bacteria that provoke the development of this terrible disease. The course of treatment and dosage are determined based on the stage at which infection was detected. In this article, we will analyze in detail how to get rid of syphilis with antibiotics.

What is a disease?

Syphilis is a sexually transmitted disease that occurs as a result of vital activity in the body of pale treponema, a bacterium that affects the skeletal system, mucous membranes, important internal organs and nervous structures.

Infection occurs in the following ways:

• during intercourse;
• from mother to child;
• through the injured dermis;
• during the birth process;
• through microcracks in the skin.

Syphilis occupies the forefront among socially significant diseases and threatens not only the health of the patient, but also his life. The danger of the disease lies in its long incubation period, which makes it difficult to diagnose at an early stage and further treat syphilis with antibiotics.

Today, a dangerous venereal disease has taken on a progressive trend, and in the absence of proper treatment, it threatens with infertility. In almost 80% of sick pregnant women, the fetus becomes infected, which often leads to its death.

Recognize the disease by the appearance of ulcers and chancre at the site of infection. Secondary syphilis is characterized by skin rashes, lesions of the mucous membranes and enlargement of the lymph nodes. At the third stage of the development of the disease, the patient develops tuberculous and syphilitic lesions of the skin, the formation of gums, metallic psychosis, weakening of motor functionality with a complete loss or decrease in muscle strength.

The causative agent of a dangerous disease constantly changes its stage, so it is important to choose a drug that has an excellent antibacterial effect in time.

Treatment

Venereologists have in their arsenal a wide range of antibacterial drugs. However, it is possible to effectively treat syphilis only with the help of several groups of antibiotics. Proven and generally recognized effectiveness is inherent in the following types of medicines:

• penicillins;
• macrolide antibiotics;
• drugs of the tetracycline series;
• ceftriaxone.

Therapeutic measures for the treatment of syphilis is a long and exhausting process that requires the complex use of drugs and an individual approach. Many pharmacological drugs for the treatment of a disease at different stages of its development have a number of limitations, including allergic manifestations.

Ceftriaxone

In the treatment of sexually transmitted infections, ceftriaxone leads to positive dynamics and guarantees the safety of the body from harmful effects. The main advantages of the antibiotic are as follows:

• quickly penetrates and has an effect on the nervous structures. This means that the drug will be effective even at advanced stages, including brain damage;
• allowed for use during pregnancy;
• the active pharmaceutical substance of the chemicals that make up the drug has a detrimental effect on the elastic molecular structure of bacterial cells, preventing their further synthesis.

The drug is excreted naturally after 6-7 hours, so it is actively used both in the clinic and in the hospital. To successfully cure syphilis with antibiotics taken, and we are talking about ceftriaxone, it is enough to make one injection per day.

This antibiotic showed itself positively not only at the primary stage of the disease, but also during the treatment of advanced forms:

• specific infection of the nervous system (neurosyphilis);
• the second stage of a long-term chronic disease (secondary syphilis);
• latent syphilis (a mode of infection in which there are no external signs of pathology).

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Features of the blood test RPHA (passive hemagglutination reaction) for syphilis

This drug is highly concentrated, but the course of treatment of certain stages will be different:

• for preventive (warning) therapy - up to 7 days;
• treatment of Primary Syphilis (initial stage) - up to 10 days;
• fresh syphilis (secondary form) and the primary stage of a latent disease - 15 - 18 days;
• the initial form of neurosyphilis - 20 days (up to 2 mg of the drug once a day);
• a severe form of the disease (inflammation of the brain - meningoencephalitis against the background of syphilis, generalized meningitis in acute form) - up to 20 days with a daily increase in dosage (intravenously up to 5 mg of the drug per day);
• the last stage of syphilis is 18 days (1 mg per day, after 14 days the course is repeated).

Ceftriaxone is well tolerated by the body, does not cause disorders in the housing and communal services, is successfully used at any age, in particular in newborns. The drug is not recommended for use if the patient is allergic to penicillin drugs, as cross-effects are possible.

Macrolides

This group of antibiotics is represented by Clarithromycin, Macropen and Retarpen. They are prescribed as an alternative for individual intolerance to penicillins. It should be noted that the most effective drug of the macrolide class is azithromycin (Sumamed). Features of the use of these funds are as follows:

• Antibiotics are bacteriostatic, that is, they do not kill bacteria, but prevent their reproduction.
• Among the side effects are frequent urge to vomit, disorders of the housing and communal services, as well as a detrimental effect on the work of important internal organs. When diagnosing renal and hepatic insufficiency in a patient, azithromycin should be taken with caution and regularly monitor enzyme and creatinine levels.
• The pharmacokinetics of azithromycin and erythromycin is such that their fate in the body is the impossibility of penetrating the barrier between the circulatory system and the central nervous structure. Therefore, with syphilitic lesions of the central nervous system, their use is strictly prohibited.

The therapeutic scheme is assigned in two versions:

• The initial stage is 500 mg of azithromycin per day (the course lasts 10 days); erythromycin is prescribed up to 4 times a day with a dosage of 500 mg, the treatment period is 15 days.
• The second stage - sumamed is prescribed exactly with the previous scheme, erythromycin is prescribed in the same dosage (500 mg up to 4 doses per day), the duration of the course of treatment is increased to 30 days.

Tetracyclines

In this group, tetracycline and doxycycline were predominantly isolated for the treatment of syphilis. Antibiotics are prescribed to patients with individual intolerance to penicillins. The appointment is determined by an alternative decision or is prescribed to the patient as an auxiliary therapy regimen. The features of the use of these drugs include:

• Tetracyclines have a number of side effects, among which are their ability to damage the auditory and vestibular apparatus, as well as irreversibly inhibit renal function. Therefore, this group is not recommended for acute kidney failure and problems with the perception of sounds.
• It is forbidden to use in children of preschool age, since the effect of active components negatively affects the formation of the rudiments of permanent teeth.
• In some cases, tetracyclines can cause adverse reactions in the body in the form of the urge to vomit, the taste of metal in the mouth, frequent and watery stools. In patients with severe and chronic liver diseases, the levels of vital gland enzymes are strictly controlled.

Schemes with the use of tetracycline antibiotics are as follows:

• Primary lues (an outdated name for syphilis) - 15 days of doxycycline (0.1 mg 2 times a day); tetracycline is prescribed 0.5 mg up to 4 times a day.
• Secondary form - the dosage is identical to the above scheme, but the course of therapy is increased to 1 month.

Penicillins

Antibiotics of the penicillin series are considered the most powerful means in the fight against syphilis. Their bactericidal action adversely affects the vital activity in the body of pale treponema, gradually destroying it. Penicillin therapy for lues at all stages of its development is approved by the Ministry of Health of the Russian Federation. The following drugs are distinguished in this group:

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Features of the analysis of RMP (microprecipitation reaction) for syphilis

• N,N-dibenzylethylenediamine solbenzylpenicillin (natural antibiotic);
• benzylpenicillin anovocaine salt;
• procaine penicillin G 3 Mega;
• bicillin 3 (bicillin-3);
• bicillin 5 (bicillin-5);
• benzathine benzylpenicillin (Benzathine benzylpenicillin).

Each of the listed antibacterial injectables is diluted in novocaine, after which it is administered intramuscularly. The first three drugs from the beginning of the list proved to be effective in the early stages. The secondary form is usually treated with benicillin 5 and procaine benzylpenicillin.

To constantly maintain the optimal therapeutic concentration of penicillin in the patient's blood, doctors perform intramuscular injections every 3 hours.

The penicillin group of drugs is well tolerated by the body and has a small number of side effects. These include the development of loose stools, which are caused by taking antibacterial drugs and last for several days.

Penicillins are indispensable for:

• early stages of syphilitic inflammation in the membranes and walls of the vessels of the spinal cord and brain (neurosyphilis);
• congenital form of lues.

In late tertiary forms, penicillin therapy is used against the background of treated syphilis, usually after 14 days of therapy with erythromycin or tetracycline.

To ensure acceptable treatment results, in the absence of the possibility of using the recommended regimens, doctors often resort to alternative medicines. In a situation with penicillin therapy, a semi-synthetic drug with a similar effect is used, namely:

• oxacillin (oxacillin);
• ampicillin (ampicillin).

The course of treatment with penicillins depends on the form of the disease, the degree of its development and the individual effectiveness of antibiotics. According to statistics, it ranges from 14 days to six months.

Important! If the patient has allergic reactions to penicillin, he is prescribed drugs of other groups, with the exception of ceftriaxone, which can provoke cross-effects.

Basic rules of treatment

No drug saves as many lives as antibiotics. Therefore, their discovery is of great importance for all mankind. Each of the groups has its own characteristics, but for all antibiotics there are strict rules for admission, which must be observed without fail. These include:

• Highly active metabolites of microorganisms (APB) are prescribed exclusively by a qualified specialist. Own conjectures and advice from friends who do not have relevant knowledge in the field of medicine cannot be the basis for self-treatment.
• It is forbidden to change the dosage of the antibiotic on a personal initiative, and even more so to interrupt the prescribed course of therapy. Failure to follow the recommendations of a specialist can cause complications and develop immunity in bacteria to the drug used.
• It is important to take APB in strict accordance with the scheme, that is, observe the hours and frequency of receptions. This is the only way to constantly maintain the required concentration of the drug in the blood. If this rule is neglected, therapeutic effectiveness will be minimized.
• It is worth drinking the medicine with purified water without gas. Other drinks will interfere with normal absorption into the blood plasma.
• Antibiotics have poor compatibility with alcohol-containing drinks, as the risk of harmful effects of toxins on the human body increases. In addition, it is recommended to abandon the simultaneous use of antihistamines, symptomatic drugs and sleeping pills.

When is a disease considered cured?

Venereologists noted some signs, grounds on which, after antibiotic therapy, the degree of cure for syphilis is assessed.

• After completing the full course of treatment, the patient must undergo non-treponemal studies (tests). These include a microprecipitation reaction with a cardiolipin antigen for syphilis and a blood test for the Wasserman reaction.
• All of the listed studies must have a negative final indicator, or the titers of non-specific antibodies must decrease by 4 or more times, in comparison with the primary analysis.
• Next, the patient is prescribed a three-fold analysis of serum in the blood plasma, with an interval between medical studies of 90 days.
• After antibiotic therapy, the patient should be free of any signs of the disease.

From this material, we learned what antibiotics treat syphilis. However, under no circumstances should you take the drug yourself. The disease is difficult to diagnose and requires constant monitoring of the stages of recovery. Remember that no one has canceled medical secrecy and you always have the opportunity to receive qualified medical care in any specialized institution in the country.

Higher medical education, venereologist, candidate of medical sciences.

Use of tetracyclines in the treatment of treponema pallidum

Of this group, tetracycline and doxycycline are approved for the treatment of syphilis. The drugs are prescribed for intolerance to penicillins as an alternative or as an additional scheme in the presence of persistent positive reactions without a decrease in titer (RPR, RMP with cardiolipin antigen). Features of prescribing drugs of the tetracycline group for syphilis are as follows:

1. Among the main side effects of tetracycline and doxycycline, their ototoxicity and nephrotoxicity should be noted, therefore this group is not recommended for chronic renal failure and hearing impairment.
2. Tetracycline and doxycycline are not used in children until they reach the age of eight, which is associated with the peculiarities of eruption and formation of permanent teeth. Tetracycline antibiotics can interfere with this process.
3. Quite often, compared with penicillins, tetracycline and doxycycline have side effects in the form of nausea, vomiting, the appearance of a metallic taste in the mouth, and diarrhea. In persons with liver damage, monitoring of liver enzymes is required.

Schemes for prescribing tetracycline and doxycycline for various forms of syphilis are shown in the table below.

The listed medicines can be prescribed both as monotherapy for hypersensitivity to penicillins, and as part of complex treatment if the patient has stable positive reactions without a decrease in antibody titer.

Tetracycline antibiotics are available as oral tablets and are used in the treatment of primary and secondary stages of syphilis. They need to be taken for 15-30 days in accordance with the therapeutic regimen drawn up by the doctor.

Due to the negative effect on the hearing aid and urinary system, tetracyclines are contraindicated in people with hearing or kidney problems. They are also prohibited for use in case of hypersensitivity to their constituent components, systemic lupus erythematosus and fungal lesions of the skin and mucous membranes.

Tetracyclines are much more likely than penicillins and macrolides to cause side effects. They can provoke disorders in the gastrointestinal tract, intestinal dysbacteriosis, anorexia, candidiasis, hearing and vision impairment, headache, changes in blood composition, and severe allergic reactions in a person.

In case of syphilis, antibiotics of the tetracycline group are prescribed to patients with allergies to antibiotics of the penicillin group. These are Tetracycline and Doxycycline.

The effect of drugs on the human body:

• these drugs affect the gastrointestinal tract, causing diarrhea, constipation, nausea and vomiting, and also give complications to the human kidneys and liver;
• have a negative effect on the auditory nerve;
• children under eight years of age cannot use tetracyclines;

Definition and types of disease

There are several types of treatment for syphilis:

• Specific. Once diagnosed, treatment is with antibiotics. But since they kill not only harmful, but also beneficial microbes, vitamins and drugs that increase the body's immune defenses are necessarily prescribed.
• Preventive. It is prescribed to persons who have been in contact with a patient with syphilis during the infectious stage of the disease.
• Preventive. It is applied to pregnant women who have had syphilis before or who have this disease at the moment. And also to children whose mothers were infected during pregnancy.
• Trial. It is prescribed for suspected specific damage to internal organs in the absence of the ability to confirm the diagnosis with convincing laboratory data.
• Epidemiological, or syndromic. It is carried out on the basis of anamnesis and clinical picture in the complete absence of the possibility of laboratory diagnostics.

What drugs to treat syphilis in the early stages? Treatment of primary and secondary syphilis is carried out according to the same methods. During therapy, a course of antibiotics is used for 2 weeks.

After a large dose of prolonged penicillin is administered. 30 minutes before the injection, a suprastin or tavegil tablet is given.

There are also some other treatment regimens. But they are all selected individually. The most popular treatment regimen is the appointment of long-acting penicillin preparations. The injections are given once a week. In the early stages, syphilis responds well to treatment, so 1 to 3 injections are enough.

Skin rashes that begin in the second stage of the disease are treated with chlorhexidine with penicillin dissolved in saline. Repeat lotions until the rash disappears completely.

For faster healing of sores on the body, they are irradiated with a helium-neon laser. Cauterize them each rash for 10 minutes daily. The course of treatment is 14 days.

Specific treatment regimens have been developed for each stage of the disease. Drugs for treatment, dosage, frequency of administration and duration of treatment are determined by the doctor.

The treatment regimen is selected taking into account the general health of the patient, his medical history, the stage of the disease and the duration of the disease, the presence or absence of comorbidities.

Usually, treatment at any stage is prescribed in two courses with a break of 1-2 weeks. At the same time, it is obligatory to control the amount of antibodies in the serum at the beginning of treatment, in the middle of the course of therapy, and also immediately after the completion of treatment.

Repeated analyzes are done six months and one year after the end of the course of treatment.

Nowadays, provided that medical help is sought in a timely manner, therapy always ends with a favorable outcome. A healthy patient is considered to be a patient who, after completing the course of therapy, has not experienced relapses for five years.

The disadvantage of treatment with this broad-spectrum antibiotic is its low permeability to the patient's cerebrospinal fluid. Sumamed is acid-resistant and has lipophilicity, which allows the drug to be rapidly absorbed in the gastrointestinal tract.

The drug has a fast action and after taking the standard for most cases of syphilis, a dosage of 500 mg, reaches its maximum plasma content after 2.5-3 hours. Best of all, the drug penetrates into the tissues and organs of the urogenital tract, respiratory tract, soft tissues and skin.

At the same time, the concentration of sumamed in tissues can exceed the concentration in the blood by more than 50 times, as well as a long half-life associated with low binding of the drug to blood proteins. It should also be noted that the concentration of the antibiotic in the foci of localization of the disease is 30% higher than in the surrounding tissues, but a high concentration does not significantly increase the effect on syphilis pathogens.

The causative agent of this dangerous disease, characterized by an alternating change of stages, indicating the spread of infection, is pale treponema.

The drug, despite the high price, is quite popular, and in practice proves its effectiveness, destroying chlamydia.

Treatment is often carried out with antibiotics in the form of tablets used at all stages of the infectious process.

Treatment of the disease in the first stage

From the stage of development of the disease, they distinguish: primary syphilis, syphilis of the second stage of development and tertiary syphilis.

The most difficult to treat is syphilis in the third stage of the development of the disease.

Syphilis in the first stage of the disease can be of several forms:

• seropositive of the first stage - a serological analysis shows a positive result for the presence of pale treponema in the body;
• seronegative of the first stage - a serological analysis shows a negative result for the presence of pale treponema in the body;
• latent syphilis of the first stage - there can be both a seropositive reaction and a seronegative reaction to the presence of a spirochete in the body.

Treat syphilis at the first stage - by the method: the introduction of penicillins every 3 hours for 24 days in stationary conditions. Patients with an early latent appearance are treated in the clinic for at least 3 weeks.

After that, you can continue treatment on an outpatient basis. The duration of the course of treatment depends on the stage of the disease and its severity.

In the case of an allergy to penicillin, macrolides, fluoroquinolones and tetracyclines and bismuth and iodine based drugs are administered to the patient. This complex of drugs is able to increase the action of the antibiotic in the body.

Trichomoniasis in women - treatment methods and consequences

Unlike other sexually transmitted diseases, trichomoniasis has a small, but still the possibility of transmitting the infection in a domestic way, for example, in baths, because. the pathogen can survive for almost a day in a humid, warm environment.

• How is trichomoniasis treated?
• Treatment of trichomoniasis in pregnant women
• What are the consequences of trichomoniasis in women?
• How to prevent the disease?

In women, trichomoniasis is often asymptomatic for a long time, being detected at certain critical periods of life (pregnancy, abortion, etc.). This is not a fatal, but very unpleasant disease, which, if left untreated, can lead to serious complications. Fortunately, the disease is well diagnosed and successfully treated.

How is trichomoniasis treated?

Treatment of trichomoniasis must be carried out by a doctor, for women it is a gynecologist or venereologist. Drugs are selected individually depending on the severity of general and local clinical manifestations.

The drugs of choice for the fight against Trichomonas are a group of imidazoles. The most popular of them is Trichopolum and its inexpensive domestic counterpart metronidazole. Assign this drug for oral administration in tablets of 0.25 g.

The doctor usually individually with each woman decides on the dose and how many days to treat trichomoniasis. Usually prescribed 0.25 twice a day for ten days or 0.5 twice on the first day, the next day 0.25 three times, then four more days 0.25 twice.

At the same time, topical preparations are used - vaginal suppositories with metronidazole. Contraindications for therapy are allergies, individual intolerance to the drug, pregnancy and lactation.

If the patient has chronic trichomoniasis, treatment is carried out in a hospital with an intravenous drip infusion of the drug metrogil (this is a form of metronidazole in solution) daily for a week. 100 ml of this solution contains 0.5 g of metronidazole.

To reduce the frequency of side effects, other drugs from the imidazole group, tinidazole or ornidazole, are often used. Tinidazole, due to its composition, is active in acute and chronic trichomoniasis, it is rapidly absorbed, side effects are mild in most patients, and recovery is faster.

Ornidazole is taken at 0.5 grams twice a day after meals for five or seven days, and alcohol and fatty foods should not be consumed during the entire course of treatment to avoid side effects. For local therapy, add one vaginal tablet to be taken once a day.

Sumamed for syphilis

What other drugs are used to treat syphilis? Drugs that help strengthen the immune system and the protective properties of the body - syphilis Syphilis - the punishment of Venus helps to reduce these properties. This is pyrogenal, aloe extract Aloe - its amazing healing properties. peat, vitreous body, vitamins.

Antibiotics are prescribed if you have a positive blood test for syphilis during a routine check-up or if you have symptoms suggestive of syphilis.

Diagnosis of pallidum spirochete

In order to establish the diagnosis of syphilis, it is necessary to conduct an examination of the body for the presence of a spirochete in the body. It is necessary to visit the office of a venereologist, who will examine the patient and send him for testing.

For laboratory confirmation of treponema in the body, you need to take a scraping from a hard chancre ulcer or a smear of syphilitic secretions from the genitals for analysis.

At 20-21 days after the entry of the pale spirochete into the body, the seropositive stage of the course of the disease sets in, and the tests show a positive result for the presence of syphilis.

Diagnosis of syphilis consists of several types of examinations and tests:

• serological diagnosis is the detection of treponema bacteria from a hard chancre scraping. According to the results of this examination, the doctor makes a diagnosis;
• treponema immobilization reaction;
• immunofluorescence reaction;
• Wasserman reaction;
• microreaction on glass;
• linked immunosorbent assay;
• microprecipitation reaction;
• passive hemagglutination reaction.

Based on the diagnostic examination and the results of laboratory tests, the venereologist draws up a treatment regimen for syphilis.

Preventive measures to avoid contracting syphilis

Preventive methods of syphilis are:

• permanent sexual partner;
• using a condom during sexual intercourse;
• when planning pregnancy, a mandatory examination of both partners;
• healthy lifestyle;
• properly balanced diet;
• observance of intimate hygiene;
• regular examination by a gynecologist, urologist and venereologist.

Treatment of syphilis with intolerance to the main antibacterial drugs

How to treat syphilis? Currently, even against such a disease as syphilis, you can find a lot of medicines that will help to significantly speed up the recovery of the patient. Consider the main of the antibiotics, the reception of which helps to overcome the disease:

1. Doxilan. It has an excellent property to destroy protein in particularly sensitive cells.
2. Miramistin. This tool has an antiseptic effect, with the help of it cell permeability is significantly increased. It is Miramistin that can strongly affect the fungus. This drug should be constantly and carefully treated intimate organs and thighs.
3. Repertan is an antibacterial agent that prevents the reproduction of pathogenic microorganisms. It is used as an intramuscular injection.
4. Rovamycin. It is administered intravenously and is used only for injection by adults.
5. Cefobid. This drug can be used in case of a disease for both an adult and a child. Injections are made intramuscularly. When using this drug, the use of alcoholic beverages is strictly prohibited.
6. Amoxicillin of the penicillin group. Contraindications: infectious mononucleosis. Side effects: vomiting, diarrhea, rash, exfoliative dermatitis. Amoxicillin is administered intramuscularly 2-3 times a day, the duration of treatment is 10 days.
7. Azithromycin. Contraindications: violations of the liver and kidneys. Breastfeeding for the duration of treatment with azithromycin is stopped. Side effects in the treatment of syphilis with azithromycin: dizziness, drowsiness, anxiety, palpitations, rash.

Patients with other skin conditions should use lower doses of antibiotics. And all due to the fact that at the moment when the drug enters directly into the bloodstream, it begins to irritate the organs and, for example, a rash on the skin can increase significantly.

Basically, a course of antibiotic treatment is prescribed for those who can not only be a carrier of the disease, but can also infect others. The main methods of such treatment include: regular intake of vitamins, the passage of ultraviolet radiation, injections using the placenta or aloe extract.

Additionally, with the main treatment, blood circulation should be improved with drugs.

And, of course, for any sexual intercourse, you should use a condom, which will prevent infection with such sexually transmitted diseases. Syphilis is a serious disease, it should be treated only by a doctor and in no case on your own.

When using antibiotics, you can not only cure syphilis, but also prevent the occurrence of all sorts of related complications. If complications are already progressing, then they can be stopped by taking additional drugs.

Currently, the most popular and effective drug used for treatment is penicillin. Although this drug is the most versatile in the treatment of this kind of disease, other antibiotics can be chosen, such as amoxicillin or azithromycin.

It is penicillin that is a drug whose action has been tested and proven. But, for example, when using other medicines, you will need to undergo a preliminary examination and pass a lot of tests to understand whether it is suitable or not.

You should also take into account the fact that it is penicillin in the smallest doses that can enter breast milk and thus not bring any harm to a small child. As for similar medicines, they can penetrate the blood to a greater extent and, of course, the breast milk of a nursing mother, which can adversely affect the child.

Like any other sexually transmitted disease, syphilis is best prevented rather than treated later for a long time. That is why you should avoid unprotected sex, it is better to always use a condom.

The main drugs that are used in the treatment are antibiotics of different groups and directions:

• penicillins;
• macroliths (azithromycin, erythromycin);
• tetracyclines (doxycycline, tetracycline);
• aminoglycosides (gentamicin, kanamycin);
• cephalosporins (ceftriaxone).

Together with antibiotics prescribed:

• antifungal drugs;
• immunomodulators;
• vitamins (B1, B6, B12);
• probiotics.

Primary syphilis treatment should begin with antibiotics:

• Josamycin 750 mg 3 times a day;
• Erythromycin - 0.5 mg 4 times a day;
• Doxycycline - 0.5 mg 4 times a day;
• Extencillin - intramuscular injections, two injections are enough;
• Bicillin - injections, two injections, after an interval of 5 days.

During this period, there is a destruction of organs and systems of the body.

Complications of syphilis can be life-threatening:

• neurosyphilis;
• syphilitic meningitis and meningovasculitis;
• syphilitic neuritis and neuralgia caused by a spirochete;
• syphilitic osteoperiostitis and treponema-induced osteoarthritis;
• spirochete-induced myocarditis and aortitis;
• hepatitis, the consequences of staying in the body of treponema;
• gastritis provoked by a spirochete;
• syphilitic nephritis;
• blindness as a consequence of neurosyphilis.

Treatment against syphilis during this period of the disease will be long and it begins with the therapy of tetracycline drugs and is supplemented with penicillins with bismuth. In case of an allergy to tetracyclines and bismuth, treatment is carried out with antibiotics of the penicillin group.

The most effective are antibiotics for the treatment of penicillin syphilis. These include:

• benzylpenicillin sodium salt;
• procaine benzylpenicillin;
• novocaine salt of penicillin;
• bicillin-3;
• bicillin-5;
• benzathine benzylpenicillin.

All drugs are diluted in novocaine and are intended for intramuscular injections.

The course of intramuscular injections is prescribed by the attending physician, based on the stage of infection with the spirochete, and penicillin therapy can last from 15 days to 60 calendar days of continuous treatment.

As alternative drugs in penicillin therapy of syphilis, antibiotics ampicillin and oxacillin are used.

Azithromycin is the most effective drug in the treatment of syphilis from the group of antibiotics - macrolides. The group of macrolides also includes:

• clindamycin;
• oleandomycin;
• spiramycin;
• erythromycin;
• roxithromycin.

Clinical indicators of the effect on the body of these drugs:

• macrolides affect the pale spirochete by disrupting protein synthesis. The effect of treatment with macroliths comes later than with penicillins;
• macrolides affect the gastrointestinal tract, causing diarrhea, constipation, nausea and vomiting, and also give complications to the human kidneys and liver;
• macrolides are not prescribed for damage to the nervous system by syphilis.

The treatment regimen for syphilitic infection is selected by a specialist individually for each patient. When developing a therapy algorithm, it will be necessary to take into account:

1. Stage and form of the disease.
2. Age and health status of the patient.
3. Presence of comorbidities.
4. The degree of drug intolerance.
5. Features of the patient's lifestyle.

There are standard treatment regimens used at an early stage of the development of the disease, during its progression, and also developed for pregnant patients.

Preventive treatment (aimed at preventing the development of infection) becomes effective if infection has occurred within the last 2 months. Sometimes a regimen is used that can suppress spirochete pallidum in the first 2 days after questionable intercourse.

The use of penicillin antibiotics

Penicillins can be used in various categories of patients with syphilis, including pregnant women. As a result of the therapy, it is possible to completely deprive the pale spirochete of the ability to live.

The resistance of the microorganism to this variety of antibiotics does not develop. The need to use alternative drugs for the treatment of a sexually transmitted disease arises only in cases of allergy to penicillin.

Most often used for therapeutic purposes:

• procaine benzylpenicillin;
• benzathine-benzylpenicillin;
• bicillin-1, 3, 5.

Azithromycin

Azithromycin is a macrolide antibiotic with a wide spectrum of action. This drug is able to prolong the therapeutic effect, helps to prevent the development of complications.

The drug is mainly used to treat uncomplicated forms of syphilis. Unlike some penicillins, azithromycin rarely has a side effect on the patient's body.

The main condition for the successful fight against syphilis with this drug is the absence of other sexually transmitted diseases in the patient. According to the standard treatment regimen, the drug is taken in an amount of 0.5 g (daily for 3-5 days).

Tablets should be taken before meals (1.5 hours) or after (2 hours later). As with most antibiotics, the course of treatment with azithromycin should be accompanied by the intake of probiotics, which maintain a normal balance of the intestinal flora.

Physiotherapy treatment

What antibiotics are used to treat syphilis if macrolides and tetracyclines are contraindicated? In this case, the patient is prescribed Ceftriaxone, which belongs to the third generation cephalosporins. Ceftriaxone is a universal drug for syphilis, allowing you to cure all its existing forms (including congenital).

It is produced in the form of a powder intended for the preparation of an injection solution. The drug should be administered intramuscularly. Since Ceftriaxone injections are painful, they are given together with Novocaine.

Ceftriaxone is contraindicated in case of individual intolerance to its constituent components. In addition, the drug should not be used in people who have previously experienced hypersensitivity reactions to carbapenems or penicillins.

Ceftriaxone is well tolerated. Side effects from it occur less frequently than when using other antibiotics, and appear mainly in the form of gastrointestinal disorders, candidiasis and allergic rashes.

Therapy for primary syphilis

Therapy of secondary and early latent syphilis

Syphilis tablets are medicines for oral administration. This infectious disease is caused by pale treponema, which affects the mucous membranes, skin and organs. Infection occurs through microtrauma or during fetal development. Syphilis occurs in 4 stages, each of which has its own treatment regimens. It will take a long time to take the pills. Assign them immediately after confirming the diagnosis.

Currently, there are various drugs for the treatment of syphilis, which give results at any stage. First of all, these are antibiotics and iodine compounds. In the past, the tablets contained mercury, to which treponema is sensitive. Currently, such antisyphilis drugs are prohibited for use due to high toxicity.

Is oral medication effective?

Treatment of syphilis with tablets is carried out at any period of the disease. However, full recovery is possible only with its primary and secondary forms. Oral administration of drugs is switched to when destructive changes in muscle tissues appear after frequent injections. However, tablets give side effects from the digestive system. With prolonged use, it is possible to develop ulcers, liver damage.

The basis of drug treatment of syphilis is antibiotics of the penicillin series. Treponema pallidum has not developed resistance to them. In the form of tablets, auxiliary drugs are also used - immunostimulants, vitamins. In certain cases, before setting up an intramuscular injection, the same drug is taken orally.

Long-acting antibiotics may be used to treat syphilis on an outpatient basis. These effective drugs quickly destroy treponema pallidum, but may have side effects. In the presence of allergic reactions to penicillin, antibacterial agents of other pharmacological groups are used:

• tetracyclines;
• cephalosporins;
• macrolides;
• streptomycins;
• aminoglycosides.

Primary syphilis is easily treatable. Tablets in this case are taken for 3 months, after which complete recovery occurs. With advanced forms, the therapeutic course can last more than 2 years. By the time syphilis passes into the tertiary period, the infectious agent develops resistance to antibiotics. In this case, preparations of arsenic and bismuth are used.

The patient is considered healthy if there are no symptoms of syphilis and the tests give a negative result within 5 years after stopping the pills.

How medicines work

The mechanism of action of such drugs depends on the substances that make up their composition. Penicillin prevents the formation of the cell membrane of pale treponema. Betalactam substance reacts with bacterial proteins. This contributes to the activation of enzymes that contribute to the self-destruction of the bacterium.

Penicillin is not destroyed by gastric juice. The maximum concentration in the blood is achieved 2 hours after taking the pill. The cure for syphilis gradually spreads to all tissues and biological environments of the body. Its concentration in the blood gradually decreases. Part of the active substance is excreted by the kidneys unchanged within 6 hours after ingestion. The elimination period is extended in the presence of diseases of the excretory system.

Types of tablets

There are many medicines that can be used to cure syphilis. Combining drugs of various pharmacological groups, the doctor makes the most effective schemes for the elimination of sexually transmitted diseases:

Application rules

Modern methods of treating syphilis involve an individual selection of drugs. This takes into account the stage of infection, the age of the patient and the presence of concomitant pathologies.

Tablets should be taken every 8 hours half an hour before meals. The duration of treatment depends on the severity of the symptoms of the disease and the results of its use in the first days. During the treatment period, it is necessary to refrain from drinking alcohol and smoking. Do not exceed the dosage prescribed by the doctor.

Treatment regimens for secondary and tertiary syphilis include drugs from several pharmacological groups. This increases the effectiveness of therapy and speeds up the healing process. In this case, it is necessary to take into account the compatibility of drugs. Penicillins effective against proliferating bacteria should not be used in combination with bacteriostatics (aminoglycosides).

When interacting with anti-inflammatory and antirheumatic drugs, antibiotics can be excreted from the body more slowly. Most of them reduce the effectiveness of combined oral contraceptives. Intravenous administration of glucose while taking penicillin can provoke the development of allergic reactions.