The method of administration of drugs for the treatment of syphilis. Treatment of syphilis

Modern methods of treatment of syphilis are focused on reducing the duration of treatment for this disease. Long-acting penicillin antibiotics created in recent years make it possible to reduce the treatment of syphilis to just a few injections. But not all patients with syphilis can be treated this way - there are indications and contraindications for short-term courses of treatment.

Modern treatment of syphilis: features

Today, experts are trying to bring to the population as accessible as possible a simple truth that has been known in medicine for a long time: it is much easier to treat the initial stages of any chronic disease than advanced ones, when the disease has already had its destructive effect on the patient's body.

This truth fully applies to such a chronic infection as syphilis. In our time, there is an improvement in the treatment of this disease in the early stages, which is carried out on an outpatient basis. Fundamentally, the treatment of syphilis has not changed much; antibiotics of the penicillin series are still used for its treatment - the causative agent of syphilis, Treponema pallidum, has not acquired resistance (immunity) to these drugs for more than half a century.

Changes occur in the duration of treatment for the initial stages of syphilis. Treatment of the early stages of syphilis is often carried out today with the help of long-acting (prolonged) penicillin preparations (durant drugs), which include benzathine benzylpenicillins. That is, modern durant drugs are actually analogues of the domestic drug bicillin.

Modern durrant drugs of the penicillin series include retarpen (pharmaceutical company Biochemi, Austria) and extencillin (pharmaceutical company Ron-Poulenc Rohrer, France).

Modern methods of treatment of syphilis in the initial stages

Modern methods of treating syphilis are easy to use, but require a thorough preliminary examination of the patient, clarification of the form and stage of the disease, as well as laboratory control of cure. For the treatment of early forms of syphilis, durant penicillin preparations are used, made using modern techniques - retarpen and extencillin. Indications for their use are primary and secondary fresh syphilis, sometimes latent secondary syphilis. Durant drug injections are carried out once a week, their number can be from one to three, depending on the stage of syphilis and its clinical manifestations.

In addition, durant drugs are recommended for the preventive treatment of persons who have had sexual or domestic contact with a patient with syphilis, provided that no more than two months have passed since the moment of contact. In this case, the drug is administered once.

The advantage of durant penicillin preparations is high efficiency in the early stages of syphilis, ease of use on an outpatient basis (instead of 8 injections per day, one injection per week is enough) and relative hypoallergenicity (preparations are prepared using modern technologies and therefore well cleaned).

But already for the treatment of secondary recurrent syphilis, many experts do not recommend the use of durant forms of penicillin - their use does not guarantee complete removal of the infection from the cerebrospinal fluid.

Effective treatment for advanced syphilis

Starting with secondary recurrent syphilis, the infection often gives complications from the internal organs and the central nervous system, so the treatment of such patients should be carried out in a hospital with the use of complex therapy.

Of the antibiotics for the treatment of late stages of syphilis, water-soluble forms of penicillin are usually used, which are administered every three hours, that is, 8 times a day. Intravenous drip administration of such drugs is more effective - this creates a more constant concentration of penicillin in the patient's body.

But antibiotics of the penicillin series often give allergic reactions, therefore, in the treatment of syphilis, antibiotics of other groups are also used, for example, tetracyclines (doxycycline), macrolides (azithromycin, josamycin, clarithromycin), cephalosporins (ceftriaxone and others).

The composition of the complex treatment of late forms of syphilis also includes bismuth preparations (biyoquinol, bismoverol) - bismuth suppresses the vital activity of causative agents of syphilis, has an anti-inflammatory effect. In the treatment of tertiary syphilis, iodine preparations are prescribed, for example, potassium iodide - it promotes the resorption of gums and tubercles that form in the skin, internal organs and the central uneven system.

Syphilis is a dangerous and widespread disease throughout the world, requiring immediate medical attention immediately upon detection. Over the past few centuries, various drugs have been used to treat syphilis. Some of them were more effective, others were less. Nevertheless, due to the fact that the causative agent of the disease - pale treponema - did not mutate during this period, it was possible to try different remedies for syphilis and develop common schemes for basic and reserve therapy. To date, drug treatment of syphilis is the main and only confirmed method of therapy. Preparations for syphilis can be prescribed not only to patients, but also to people who are in close contact with them, for example, their children or cohabitants.

Preparations and means for the treatment of syphilis

Medicines for syphilis

Patients should be aware that this disease is very serious and, without proper regular therapy, can lead to the death of the patient. You should not self-medicate by taking syphilis medications that are not prescribed by a doctor, increasing or decreasing the dosage on your own. This is due to the fact that the disease often manifests itself as a variety of concomitant HIV diseases, negatively affects the mucous membranes, skin, and, with a long course, the work of many organs. In addition, many possible forms of development can be resistant to one or another anti-syphilis drug. So, for example, in the fight against neurosyphilis, it is necessary to use those agents that easily penetrate into the cerebrospinal fluid. Otherwise, therapy will be ineffective.

Treatment of syphilis with pills

Treatment of syphilis with pills, as a separate form of therapy, is justified in the initial stages of the disease and only if the patient does not have other HIV infections. Also, preference for drugs against treponema in tablet form is given if, as a result of long-term therapy, there have been changes in the structure of the muscles that prevent the normal absorption of drugs administered with injections. Many modern drugs, produced in the form of tablets, are successfully fighting such a difficult form of the disease as neurosyphilis. As already mentioned, this form of release of medicines avoids destructive changes in the gluteal muscles and excessive traumatism of blood vessels, however, the gastrointestinal tract is substituted for the main blow of side effects. At the first manifestations of peptic ulcer, inflammation of the kidneys or liver, most of these drugs have to be abandoned.

In addition to the main therapeutic effect, tablets in the treatment of treponema are used as an auxiliary therapeutic agent, immunostimulating or anti-allergic. In the latter case, they are prescribed before the first injection of a drug not previously taken, half an hour before the injection.

Injections for syphilis

Injections for syphilis are given either intravenously or in the upper quadrant of the buttocks. In most cases, the second option is much more preferable, since they do not have such a negative effect on blood vessels as in the first case. However, in particularly severe cases, it is intravenous injections that are prescribed. Intramuscular injections are always made in the buttock, each time choosing a new place for the next piercing. The correct calculation of the thickness of subcutaneous fat is very important for systematic treatment, since drugs are absorbed from the subcutaneous tissue much more slowly, and repeated injections in the same place will cause pain in the patient, severe muscle swelling and excessive growth of connective tissue, followed by scarring. Therefore, in medical institutions, the first injection is made closer to the line of the spine, each time moving away from it, alternating either the right or the left buttocks for the next punctures.

Recently, more and more often you can find ads for the treatment of syphilis with one injection, but as practice shows, this is just another way to lure money from patients, and even if the symptoms of the disease temporarily disappear, not 1 or even 4 injections can cure a person! But they will be able to translate the disease into a latent form, thereby aggravating the situation.

Treatment of syphilis with mercury was one of the earliest means of combating this disease, which began to be used as early as the 16th century. And although Hg in many cases helped fight the disease, unnecessarily large dosages of drugs containing mercury, tablets based on it, injections into the vein and inhalation of vapors often led to side effects that turned out to be much more difficult to cope with than the disease itself. Therefore, when treated with this remedy, there was a very high mortality rate of patients.

Despite this, many doctors continued to poison their patients with incorrectly calculated doses or suggested that they constantly carry special bags with evaporating mercury. And only in 1865, Russian scientists Konoplev and Sokolov proposed the use of sublimate injections, which make it possible to more accurately calculate the dosage of the drug administered to the patient.

Today, traditional medicine prescribes medical treatment of syphilis with mercury in some cases. Also continue to use this remedy and representatives of homeopathy. With regard to traditional medicine, it is justified to administer small doses of Hg to newborns and young children, if they have lesions of the skin or mucous membranes. Usually, substances are administered in the form of a mixture or powder, so the doctor, suspecting pale treponema, may prescribe them secretly, waiting for the results of the examination.

Sometimes mercury ointments are used to rub into the skin, but only in cases of unsuccessful conventional treatment or poor absorption of the gluteal muscles.

Another remedy used today in the treatment of patients is mercury injections, the indications for which are the same as for conventional antibiotic injections. At the same time, the course of treatment is longer, and there are more side effects.

Treatment of syphilis with antibiotics

In modern medicine, it is the use of antibiotics for the treatment of syphilis that is the most justified solution, since these medications, in most cases, show a quick result in the fight against treponema pallidum with minimal side effects. Antibiotics for syphilis can be prescribed both in the form of tablets and in the form of injections, depending on the stage of development of the disease, the presence of chronic diseases, allergic reactions, and much more.

Currently, the most common antibiotics are penicillins. They are assigned first. In case of contraindications to them, they begin to use other means: macrolides, cephalosporins, tetracyclines.

Penicillin

Treatment of syphilis with penicillin was first used in the 40s of the last century. Due to the fact that the virus has not mutated during this time, it remains the No. 1 drug in the treatment of this disease. Penicillin for syphilis shows an effectiveness that is not available to many other broad-spectrum antibiotics, but it often causes an allergic reaction. Therefore, as soon as the diagnosis is confirmed, an allergy test is taken from the patient, and if the result is negative, drug therapy is started. Penicillin, after its administration, begins to act quickly in the body, which is its undoubted advantage, but the speed of its removal from the body forces doctors to prescribe injections at intervals of 3-4 hours, which makes outpatient treatment with this drug impossible and requires the patient to be hospitalized.

In the case of a positive allergy test, the doctor decides for himself which drugs to treat syphilis in this particular case.

Bicillin

Bitsillin for syphilis is prescribed either as the main drug or as a medication to complete the successful treatment of the disease. There are 4 types of drugs with a common name - bicillin. They differ from each other in the concentration and composition of the main active substances, which affects not only its antibiotic properties, but also the different frequency of injections during therapy. So, Bicillin 3 is usually administered twice a day, while the drug with number 1 is administered once a day. For outpatient treatment or to help other antibiotics against pathogens, bicillin 5 is often prescribed, which is excreted from the body in 4-5 days, which allows 1-2 injections per week, while the same penicillin requires 3-4 injections in a day.

With pronounced allergic reactions to penicillin drugs or bicillin, it is prohibited to prescribe this drug.

Ceftriaxone

Ceftriaxone for syphilis is prescribed in case of allergy to penicillin preparations. It has unique properties and effectively fights against most pathogens, including Treponema pallidum. The drug has a slightly less pronounced effect compared to penicillin, but its half-life is about 8 hours, which allows you to prescribe injections once a day without requiring hospitalization of patients. Ongoing studies have shown its effectiveness as a medical reserve for primary and secondary forms of syphilis, however, little experience with its use and the lack of data on harm to pregnant women does not allow recommending the drug to pregnant women and children.

Doxycycline

Doxycycline is another antibiotic that has been widely used since the 1990s. On average, taking doxycycline twice a day, the treatment of syphilis lasts 10-30 days, which is only slightly longer than with benzylpenicillin drugs. The release form of this drug is ampoules. On the day, the patient is prescribed 2 injections of 1 g, trying to distribute them over time at equal intervals. Doxycilin has a slight photosensitizing side effect on the skin, so in the summer during the treatment period, patients are advised to stay in the sun as little as possible. Also, the drug negatively affects bone growth, which should be considered when prescribing it to children.

Sometimes doxycycline is used at the stage of preparing patients in subsequent penicillin therapy, especially in cardiovascular syphilis.

When choosing doxycycline, the doctor must take into account that this drug should not be prescribed to pregnant women.

Sumamed

With syphilis, sumamed is used as an analog drug. This agent is usually referred to as bacteriostatics, which does not prevent it from showing an association constant with ribosomes 8 times higher than that of other drugs of the azalide series. This allows to achieve effective suppression of protein synthesis in the early stages of the development of the disease, and does not allow the disease to develop. If the patient has a non-early form of the disease, sumamed can be prescribed as an additional non-specific medication to speed up the cure for neurosyphilis, a congenital form of syphilis, a recurrent or latent type of disease, and also in the presence of other pathologies.

A positive property of the drug is its ability to accumulate in tissues to a concentration that exceeds its content in the blood by 50 times, while sumamed will be excreted from the body for at least seven days. The disadvantage of this medication is impermeability to the cerebrospinal fluid and a negative effect on the liver and kidneys.

Azithromycin

With syphilis, azithromycin began to be prescribed relatively recently. Since this drug is new, we immediately conducted experiments on its safety and a comparative test for effectiveness. Tests were carried out in the USA for seven years. According to the test results, a similar effectiveness of medications and an almost complete absence of side effects were established. But mild side effects were observed quite often and accounted for about 60% of all cases of treatment with azithromycin, however, serious dysfunctions of the body were manifested to a much lesser extent than in the control group taking penicillin.

Despite the encouraging result of the experiment, the effect of the drug on the body of pregnant women has not been studied. In addition, if the patient has several concomitant HIV diseases, azithromycin may be almost completely useless.

Tetracycline

Treatment of syphilis with tetracycline is prescribed mainly in the initial stages of primary and secondary disease, if the patient needs to switch from injections to tablets. It is necessary to take tetracycline four times a day, at regular intervals for 15-40 days, depending on the form of the disease.

When prescribing this drug, it is necessary to warn the patient about the undesirability of drinking milk during the period of therapy, as well as substances that reduce the acidity of the stomach. If therapy takes place in the summer, then they warn of the need to hide from the sun's rays.

Tetracycline is not prescribed for preschool children and pregnant women.

Erythromycin

Erythromycin is almost never used in syphilis if it is possible to use a much more effective benzylpenicillin, however, as a reserve drug, it has proven itself well. Erythromycin is classified as a macrolide.

Erythromycin is often prescribed to young children, as it is currently considered the safest anti-syphilis drug. With neurosyphilis, this remedy is useless, since it does not penetrate into the cerebrospinal fluid.

The harmlessness of erythromycin negatively affected its aggressiveness to the causative agent of the disease, so this remedy is often combined with various kinds of bismuth drugs or a longer course of therapy is prescribed.

Amoxicillin

Amoxicillin for syphilis is used as a semi-synthetic analogue of penicillin. The advantage of this tool is a wide range of its action. Acid resistance, which made it possible to produce it in tablets for oral use and the speed of action after taking medications, allows reaching the maximum concentration in the blood in 2 hours. Good absorption of amoxicillin allows you not to tie the hours of admission to food. The main thing is to adhere to equal intervals between the use of the drug.

It is not advisable to use this remedy instead of penicillin in the absence of allergic reactions, since it is significantly inferior in effectiveness to benzylpenicillin. Also, do not combine amoxicillin with antibacterial agents, as they will suppress each other.

Ampicillin

In syphilis, ampicillin is used as a semi-synthetic analogue of penicillin. In its structure, the drug is extremely similar to penicillin, both in terms of its effect on gram-negative and gram-positive microorganisms. Therefore, it is often prescribed as a broad-spectrum drug when the disease is already clearly established, but there is no specific data on its etiology.

The similarity with penicillin allows you to use not only the dignity of the drug, but also its disadvantages. For example, if the disease is caused by microorganisms that destroy penicillin, then ampicillin will also be destroyed.

Good results can be achieved by combining ampicillin treatment with B and C vitamins.

Alternative treatment of syphilis

Treatment of syphilis with folk remedies as a separate method of therapy, without contacting doctors, is not able to cure the patient, but only starts the disease, which can cause death.

But the use of various herbs as an additional method of influence will not only speed up the recovery of the patient, but also reduce, and in some cases help to avoid the negative consequences of taking antibiotics that adversely affect the human body.

But before you start taking certain herbal infusions, you should consult with your doctor to find out what consequences they will have on the drugs you take, and whether they will harm the body more than help.

Treatment of syphilis with homeopathy

The treatment of syphilis with homeopathy began to be used in the 18th century. The principle of this unconventional effect on the body is an attempt to awaken the patient's immune response by giving him drugs that can also cause symptoms of pale treponema in a healthy person. Usually, preparations with diluted mercury and iodine are used for this, but in small proportions, which they drink weekly, alternating with each other.

From a theoretical point of view, this is interesting, but after diluting the active substance in a ratio of 1/100, it is not possible to talk about benefit or harm, since such small numbers are within the limits of mathematical errors.

Whatever medication you start the fight against syphilis, the main condition for successful treatment remains the systematic intake of prescribed medications in the dosage indicated by the doctor.

Syphilis refers to a chronic sexually transmitted disease, the main causative agent of which is the bacterium Treponema pallidum (Treponema pallidum). The main route of transmission of pathology is sexual, infection from mother to fetus is possible. The disease affects not only the mucous membranes, but also all organs, including the bone and nervous system.

Therapy is a complex task that requires a complex impact. The basis of treatment is drug therapy, as a rule, tablets for syphilis (antibiotics, antibacterial agents) are prescribed.

Therapy of syphilis with tablets

Syphilis and its treatment with drugs is indicated at all stages of the development of pathology, but the greatest effectiveness is noted in the initial period.

As a rule, the treatment of syphilis with tablets involves taking antibiotics of the penicillin group, since the bacterial agent is the least resistant to them. Penicillin preparations can be prescribed both for oral administration and for injection administration. In more advanced cases, a complex effect is carried out - taking penicillin in the form of tablets and an injection of the same drug an hour later.

The most popular drugs for penicillin syphilis include the following medicines:

• Bicillin;
• Retarpen;
• Extencillin.

Drugs with a highly effective action of the relative main causative agent of the disease, have a low threshold for the development of an allergic reaction, and are well tolerated by patients.

If the patient has an allergy to the penicillin series or with high resistance, the doctor prescribes an alternative - macrolide group drugs:

• Erythromycin;
• Rovamycin;
• Midecamycin.

These medicines can be replaced by others. Here it is possible to use tablets of the tetracycline group. Betalactam agents - fluoroquinolones are also suitable for the treatment of treponema: Ceftriaxone, Ofloxacin.

As a rule, the medicine for syphilis in the form of tablets is prescribed in the early stages of the pathology, the duration of therapy is 8-12 weeks. The advanced stages of the disease, turning into a chronic form, require long-term treatment, often a year or more is needed. In such cases, the use of toxic drugs is assumed, since at this stage the treponema already has resistance to various groups of antibiotics.

Currently, it is realistic to treat syphilis, only the selection of adequate therapy and high qualifications on the part of a venereologist are necessary. In the absence of a recurrence of syphilis over the next five years, the patient is considered completely healthy.

Preparations

Today, pharmaceutical companies offer many means to suppress infection. The most popular is the tablet form of funds. Which pills to choose is the task of the treating specialist, he will select the required dose, how to drink correctly and the duration of the intake. Below is an example of medications most often prescribed by venereologists.

Doxilan

The main active ingredient - doxycycline, is an antimicrobial agent. In action with respect to the causative agent of syphilis, it is similar to the means of the tetracycline series, which allows it to be prescribed as an analogue.

The main indication for the use of Doxilan is the diagnosis of syphilis. However, due to its broad antibacterial effect, the drug is effective against coxiellosis, typhoid, malaria and other infectious pathologies. It is prescribed for the development of an inflammatory process in the pelvic organs.

The tool is not used in pediatric practice (up to 10 years of age), as well as in patients with increased individual sensitivity to the components.

The dosage depends on the general condition of the patient and the type of infection. The standard intake with a body weight of 50 kg is 200 mg twice a day. Then the dose is reduced to 100 mg. In pediatric practice, the dosage is selected depending on the weight - 4 mg per kg. With the diagnosis of syphilis, the duration of treatment is 10-14 her.

Perhaps the development of side effects in the form of skin rashes, disruption of the digestive system, nausea. If you have these symptoms, you should stop taking the pills and consult your doctor about a replacement.

Rovamycin

It is a macrolide drug, has a persistent bacteriostatic effect. Effective against the causative agent of syphilis, chlamydia and meningitis.

It is prescribed in the complex therapy of STDs, allows you to cure: syphilis, chlamydia and gonorrhea. The bacteriostatic effect of the drug allows you to eliminate inflammation of the respiratory, as well as the genitourinary system.

It is possible to buy Rovamycin in tablet form and as a powder for parenteral administration. Dosage and course of treatment is selected in each case individually. The drug is not prescribed in the presence of pregnancy, as well as severe liver damage (hepatic encephalopathy, hepatitis). Caution should be used in patients with pathologies of the excretory system.

As a rule, Rovamycin is well tolerated by patients, only the use of high doses can lead to the development of nausea and vomiting. Treatment in this case is symptomatic, hospitalization or inpatient placement of the patient is carried out in rare cases.

Bicillin

The drug belongs to the group of penicillins, natural origin. The action of the agent is based on the suppression of the synthesis of cell membranes, thereby suppressing their further reproduction. The greatest efficiency is observed when exposed to gram-positive bacteria, gram-negative - the therapeutic effect is lower.

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Features of the treatment of syphilis during pregnancy

Pharmaceutics offers three versions of the drug with different active ingredients, the attending physician will help you choose the best option.

Bicillin is indicated for patients diagnosed with gonorrhea, syphilis. In some cases, it is used in the treatment of infectious process of the respiratory system.

Use during the period of gestation is carried out according to indications.

To reduce the risk of developing a fungal infection, which can happen while taking Bicillin, vitamins of groups B and C are additionally prescribed.

Miramistin

It has a fairly high efficiency in the treatment of sexually transmitted diseases. Actively fights against all gram-negative and gram-positive bacterial agents, including effective against bacteria resistant to antibiotic therapy.

In addition, it has a pronounced therapeutic effect against fungal infection. It is more often prescribed for syphilis, as it has proven its effectiveness.

Miramistin is effective against STIs, with infectious lesions of the mucous membranes and skin. Has found wide application in gynecology, urology and surgery. It is a powerful antiseptic.

Minoleksin

It belongs to the tetracycline group of antibiotics, has a high bacteriostatic effect, and has a wide antibacterial spectrum of activity.

Available in the form of capsules for oral use. Dosing of the drug is selected individually, depending on the severity of the course of syphilis. It is taken after eating, it is recommended to drink warm milk to reduce the risk of inflammation of the intestinal mucosa.

At the beginning of the course of therapy, the dose should not exceed 200 mg per day, then it is reduced to 100 mg. The maximum daily dose is 400 mg, only on prescription.

Minoleksin is not prescribed simultaneously with penicillins, as it reduces their effectiveness. The duration of therapy is negotiated with the doctor, on average, the course of treatment is 7-14 days.

Cefobid

The second name of the drug is Cefoperazone, according to the main active ingredient. It has a bactericidal effect, has a wide range of therapeutic effects, including active against Staphylococcus aureus.

The main purpose is the treatment of STIs (syphilis, chlamydia, gonorrhea). But, due to its high efficiency, it is used in urological practice to suppress bacterial agents in diseases of bone structures and postoperative complications.

Not recommended at high risk of developing allergic reactions, during gestation and during lactation. In case of an overdose, dyspeptic manifestations in the form of vomiting, nausea, and diarrhea are possible. It is not recommended for patients who have impaired hemostasis, the drug reduces the coagulation process.

Cefotaxime

The active ingredient is similar to the name of the antibiotic, it belongs to the third generation beta-lactams. It is possible to use during pregnancy, but strictly according to the doctor's indications.

Cefotaxime is used in the treatment of sexually transmitted pathologies and various genitourinary infections. It is actively used in ENT practice and in the treatment of skin diseases.

Dosing is selected taking into account the characteristics of the type of infection and general well-being. The main contraindication is hypersensitivity to beta-lactams and penicillins. It is also not recommended if the patient has severe liver failure.

Bismoverol

The drug belongs to the group of antisyphilitic medicines, it is used at all stages of therapy and at any stage of pathology. It is used both in the therapy of adult patients and in pediatrics.

Dosing is selected according to the age category of the patient, the stage of syphilis and the severity of its course. The drug is highly effective, but in some cases it is contraindicated. Not applicable in patients with the following comorbidities:

• acute cardiovascular failure;
• diabetes mellitus (any type);
• kidney and liver failure.

As a side reaction, it is possible to develop various forms of neurology, deterioration of the condition of the gums - bleeding, an increase in the concentration of protein in the urine test.

Penicillin

Today it is one of the most popular and effective drugs against syphilis infection. Widely used in the treatment of other sexually transmitted diseases. Penicillin has a wide range of therapeutic effects, is used in various areas of medicine - gastroenterology, gynecology, dentistry and others.

Penicillin is available in tablet form and for injection. It is often prescribed in the form of injections, since it has the highest percentage of effectiveness. It is administered intramuscularly, the dosage is determined by the attending physician.

• The main indication of the drug is the treatment of sexually transmitted pathologies (syphilis, gonorrhea, chlamydia). The drug is actively used in the treatment of the inflammatory process of the lining of the brain - meningitis, with various degrees of burns, in the case of a purulent process of soft tissues, and so on.
• Such a variety in the use of the drug is based on the wide possibility of its use - orally, in the form of injections under the tongue, spinal canal, as inhalations. Also used as a solution for washing the affected area or rinsing for diseases of the oral cavity.
• Penicillin is not used in the presence of an allergic reaction to the drug. To date, there have been quite a few cases of intolerance to this drug, compared with other groups of antibiotics. With an incorrect dosage, it often provokes reactions from the gastrointestinal tract - nausea, vomiting.
• When using Penicillin during pregnancy, the possible intolerance of this antibiotic by the fetus should be taken into account. In such cases, as a rule, it is recommended not to use the drug, but to replace it with a more gentle one, with the least risk of developing such an effect, for example, Macropen or Azithromycin.

The treatment of syphilis is a system of medical measures and manipulations designed to suppress the causative agent of infection, eliminate the disease itself, and correct the harm caused to the body. appears as a result of infection with pale treponema and is a sexually transmitted disease, since the main source of transmission of the pathogen is sexual contact, especially unprotected. However, the sexual route of infection is not the only one characteristic of this disease. Transmission of syphilis is possible in everyday life, during blood transfusion, during surgical operations.

How successful the therapy of this disease can be if it is detected on time and treated adequately, the disease can be just as dangerous if you do not follow the doctor's recommendations or do not seek medical help at all.

Syphilis in history: how they fought the disease before

The first cases of syphilis have been known to historians since ancient times. A massive epidemic of infection first shook the European continent at the end of the 15th century - then around 15% of its entire population was infected throughout Europe. The outbreak quickly spread across the mainland, and lasted about 50 years. The origin of the disease, which "decimated" the population in numbers on a par with the plague, is attributed by historians and other scientists to Columbus's earlier trip to South America. The sailors who returned on his ships were partially infected with syphilis, which had previously been transmitted to them from the women of the West Indies.

The beginning of the Italian wars contributed to the massive spread of the infection, when the French army invaded Italy. Among the French soldiers were those who were already infected with the disease. Syphilis spread across Europe in about 1 year. After one and a half to two years, cases of defeat were recorded in Turkey, China, and North Africa.

The study of the disease in order to determine its nature and methods of treatment began in the Renaissance - until this period, syphilis was generally considered a disease of uncertain origin. In the 15-16th century, many scientists and doctors compared syphilis with gonorrhea, believing that this is one and the same disease. This direction in medicine was called unitarism - it attributed the signs of all the venereal diseases at that time to syphilis. The founder and main representative of this idea was the English doctor Genter, who tested and studied the development of syphilis and gonorrhea on himself. In 1767, he injected himself with pus from the body of a patient with a hard chancre. After some time, he developed the characteristic signs of syphilis, namely a hard chancre, which was then considered a sign of all venereal diseases.

Only 70 years later, this event could be studied more thoroughly and correctly interpreted. True, for this it was necessary to conduct another experiment, in this case already associated with the infection of a large number of prisoners sentenced to death without their consent, without providing them with medical care. In this way, the French physician Rikor was able to distinguish between gonorrhea, syphilis and other sexually transmitted diseases that had previously been confused with each other, and dispelled doubts that all of their manifestations belong to one disease. Of course, there is no question of the humanity of such a research method - in order to be able to treat patients with syphilis in the future, almost 1,400 people were infected with syphilis or gonorrhea. The results of the experiment became the basis of the science of syphilidology.

One of the first venereologists who began to study syphilis was the Frenchman Jean Astruc. In 1736, under his editorship, a manual on venereal diseases was published - the first fundamental work on this topic, most of which was devoted specifically to syphilis.

The treatment of the disease during the Middle Ages was very primitive and was based on the introduction of mercury preparations into the body in the form of ointments or vapors. The urethra of patients was subjected to instillation with plantain juice, white lead - all these substances had an anti-inflammatory effect on the affected genitals, and, as it was believed, helped to cure syphilitic gums. For the procedure, catheters made from the skin of various animals were used.

In those days, the appearance of syphilis in a person was associated with sexual promiscuity, and against the background of the mass ignorance of the population and general religiosity, it was considered “God's punishment”, and treatment was carried out as a punishment. Relatively mild remedies were also used - diuretics and diaphoretics, for example, honey syrup, rose honey syrups, aloe decoctions. However, the main method of treatment - mercury - in this context was very similar to bullying. First, the patient was subjected to severe scourging, supposedly to atone for his sin. Then, for several days, the patient received a laxative, and at the end of such preparation, he was placed in a special barrel and smeared with mercury ointment twice a day.

At that time, they did not yet have a specific idea about the toxic properties of mercury vapor, and against the background of the fact that in some cases recovery did occur, the mercury treatment method remained the only way to save patients with syphilis. Approximately 80% of patients subjected to such treatment died during treatment, and the rest died within the next 5-10 years.

In Russia in the 16th-18th centuries, to get rid of syphilis, doctors used "Mercury" - a mercury ointment that was rubbed into the patient's skin. In remote places of Siberia, where until 1861 there were no medical institutions, syphilis was treated with mercury, silver, vitriol, sublimate, bear and wolf bile, deer blood, and most patients generally resorted to the “services” of healers and shamans.

Until the beginning of the 19th century, only such methods were used in the treatment of the disease, mainly with mercury, until the doctors of that time suggested the use of iodine chloride preparations for the treatment of syphilis - iodine was used to destroy the pathogen. In the 18th century, a surgical method for treating the disease was also proposed, although it was more related to its external manifestations - it was proposed to excise the formed chancre. Naturally, this technique had no effect, since the infection itself remained in the body.

The use of mercury, silver, bismuth preparations was fatal for patients, since these substances introduced into the body are toxic to it. Even if syphilis receded, a person received metal poisoning and damage to internal organs.

In the second half of the 19th century, the Odessa physician Rosenblum began to successfully treat progressive paralysis in patients by inoculating them with relapsing fever, although it is officially believed that this method was developed by the Austrian Wagner-Jaren in 1914. In 1858, the physician Yu. Lukomsky wrote a scientific work on the treatment of syphilis by inoculation with cowpox poison.

Treatment of syphilis by inoculation of malaria is another way to "treat" patients with a sadistic bias, which was practiced until the 20th century. This method was called pyrotherapy and was based on the fact that the causative agent of the disease is able to exist and multiply in the human body in a fairly narrow temperature range. The causative agents of the disease - plasmodia - enter the body through the bite of a malarial mosquito. They penetrate the bloodstream and enter the liver, which they begin to gradually destroy. When the pathogen enters the bloodstream, a toxin is formed, due to which the body is sharp. In this case, treponema in the body dies due to high temperature.

In 1909, a breakthrough was made in the treatment of the disease. The German scientist and Dr. Ehrlich proposed the use of a derivative of arsenic - salvarsan and neosalvarsan to get rid of syphilis. The drugs had sufficient clinical efficacy, higher than mercury drugs, but their side effects were similar to "Mercury".

Beginning in 1921, drug therapy began to include bismuth preparations:

• Bioquinol;
• Bismoverol;
• Pentabismol.

From about the 1930s, bismuth products began to gradually replace mercury and iodine drugs in the treatment of syphilis. A somewhat smaller number of side effects testified in their favor, although against the background of less efficiency. The use of these drugs in clinical practice was actively noted until the 90s of the last century. It should be noted that bismuth is also used in modern medicine as an element of a complex treatment regimen for chronic syphilis.

In 1943, American scientists Arnold, Harris and Magoneu made a revolution in medical science - they discovered Penicillin. Pale treponema is highly sensitive to Penicillin preparations, while they do not cause such harm to the body as mercury vapor or iodine compounds.

Bismuth and arsenic salts are practically not used today in the treatment of syphilis due to their toxicity - they treat the disease only in cases where antibiotics do not help due to the pathogen's resistance to them.

Modern methods of treatment of syphilis: general characteristics

It is known that bacteria and microorganisms over time have learned to develop a certain level of resistance to existing antibiotics, which they have been exposed to for a long time. The group of penicillin antibiotics refers precisely to such drugs - today they are little used to treat infectious diseases, since many groups of bacteria have already developed resistance to them. However, Treponema pallidum is one of the few microorganisms that actively respond to Penicillin and respond well to treatment with it, having no defense mechanisms against penicillin exposure.

If the patient is allergic to the substance and its derivatives, or if the treponema strain that caused the disease has been identified and confirmed resistance to penicillin, the patient is prescribed a different type of treatment - using macrolide drugs, such as Erythromycin, tetracycline derivatives or cephalosporins.

The use of aminoglycosides has the property of suppressing the activity of treponema only in large doses, which are quite dangerous for the patient's body. Aminoglycosides are not used as an element of monotherapy.

If a patient is diagnosed with neurosyphilis, penicillin preparations are administered not only intramuscularly and orally, but also endo-plumbally. In addition, such a patient is prescribed pyrotherapy to increase the permeability of the blood-brain barrier.

In addition to antibacterial drug treatment, a patient with syphilis is shown the appointment of immunostimulating agents. Immunostimulants are administered intramuscularly, and in addition, vitamin therapy and general strengthening agents are prescribed to enhance the body's natural defenses. There is no special diet for syphilis, but it does not hurt to adhere to the general principles of a healthy diet.

The tertiary period of syphilis in a good condition of the patient, and in the presence of treponema resistance to antibacterial agents, is cured by a combination of antibiotics with a course of bismuth or arsenic derivatives. These drugs cannot be bought in pharmacies - due to their toxicity, they are available only in special medical institutions.

The principles of modern treatment for syphilis implies not only the impact on the patient himself, but the need to treat his sexual partners in the last three months, if primary syphilis is diagnosed, and in the case of secondary syphilis, in the last year.

The appointment of a therapy regimen can only be carried out by a qualified venereologist, based on the results of the examination, patient interviews, clinical examinations and tests. Self-medication is not allowed.

How long can the treatment of syphilis last and is it curable? The process of therapy aimed at effectively getting rid of the disease can last from several months to several years, for example, if a patient is diagnosed with the primary form, he will have to undergo continuous drug therapy for at least two months. With secondary, tertiary, late syphilis, treatment can stretch for 4-5 years.

Depending on the condition of the patient, therapy can be carried out both on an outpatient basis and with placement in a hospital. Patients with syphilis as part of the medical examination are taken for mandatory registration in the KVD - skin and venereal dispensaries.

The most effective is the therapy with water-soluble penicillins administered by injection every 3 hours for 24 days, but it can only be carried out in a hospital, under the supervision of a physician.

Treatment for early stage syphilis

It is possible to identify a lesion during the incubation period that precedes the appearance of the first symptoms only if you pass special serological tests, which is why the disease is extremely rarely detected during this period. When a patient has a characteristic chancre and lymphadenopathy, when visiting, or a specialist may already suspect syphilis in a person. Often it is detected at an early stage during preventive examinations. In such cases, you need to take emergency measures to influence the pathogen in the body.

Standards for the treatment of the initial stage of the disease require a complete renunciation of sex for the duration of therapy. In addition, the doctor will require you to stop taking alcoholic beverages. The entire treatment system is based on the use of penicillin antibiotics and antimicrobials, which already create a load on the liver.

In addition, the doctor will offer to send for examination all the patient's sexual partners with whom he had contacts in recent times.

Penicillin antibiotics form the basis of treatment, and in addition to a course of drugs like Ampicillin, Bicillin, Retarpen, the patient is also prescribed a course of supportive drugs, vitamins, and immunomodulators.

Therapy with tetracycline antibiotics, macrolides and cephalosporins is slightly less effective, but is indicated for those who are allergic to penicillin.

Is it necessary to hospitalize a patient with the initial stages of syphilis? If we are talking about the primary form, treatment at home is allowed, but it must be possible to carry out a course of antibiotic injections according to the scheme. If the patient is diagnosed with secondary syphilis, he is likely to be placed in a hospital.

After the end of treatment of the primary seronegative type of the disease, the patient is registered and under the supervision of a venereologist for the next year. Those who have been diagnosed with seropositive syphilis are observed by the doctor for another 3 years after receiving negative results of control tests.

Testing for control after the end of treatment is carried out every 2-3 months during the first 6 months, and then once every half a year.

Treatment of pregnant women with primary syphilis can only be carried out with drugs that do not harm the fetus - penicillin antibiotics and Ceftriaxone. In order to prevent the onset of serious consequences for the child and mother, a pregnant woman undergoes two mandatory courses of treatment - the main one, which is carried out in a hospital, and a preventive one, which is allowed to be carried out and on an outpatient basis.

In the first and second trimester of pregnancy, the expectant mother is also prescribed a double course of treatment - first at the time of diagnosis, and then - for a period of 20-24 weeks.

Primary syphilis in children is treated in the same way as in adult men and women. The patient is injected with antibiotics for 10-14 days, and immunostimulating agents are prescribed in the form of tablets, suppositories or injections. Secondary syphilis, including congenital, requires repeated courses of penicillin therapy until the pathogen disappears from the body. For newborns, macrolide preparations are provided.

Preventive treatment is prescribed to those people who have had contact with patients with syphilis, both intimate and domestic, if no more than 2 months have passed after contact. On an outpatient basis, the patient is prescribed a course of 4 injections of bicillin-1, bicillin-3 or bicillin-5. It is allowed to use Retarpen or Extencillin in a single dose with a concentration of 2.4 million units.

In a hospital, preventive treatment measures involve the administration of Penicillin sodium or potassium salts at a dosage of 400,000 units every three hours for two weeks.

For patients who become infected after a blood transfusion with syphilis pathogens, a treatment regimen is provided similar to that for patients with primary or secondary fresh syphilis.

How is advanced syphilis treated?

Latent, late and chronic types of the disease are the worst to treat. At this stage, the body has already suffered quite a lot from the infection, so the patient develops various concomitant lesions and diseases that affect all internal organs and systems.

Therefore, the treatment is based on the principle of complexity - the attending physician must choose not only the main therapy for the destruction of the infection, but also a set of concomitant medications to correct violations in the functioning of systems, tissues, organs.

Manifestations of tertiary syphilis are exposed to drugs with the active substance benzylpenicillin. For patients with allergic reactions to penicillins, desensitizing therapy is prescribed, as well as tetracycline drugs, cephalosporins, polysynthetic penicillins.

If the patient has intolerance to any antibiotics, he is prescribed macrolide drugs.

Treatment for patients with no concomitant damage to the internal organs is as follows: water-soluble penicillin is administered at 1 million units 4 times a day, the total daily dose is 4 million units. The duration of the course is 28 days. Then a break of 14 days is made, after which a similar therapy lasting 28 days is repeated again. It is also allowed to use the novocaine salt of penicillin, twice a day at a dosage of 600 thousand units. If procaine-penicillin is prescribed, it is administered by injection of 1.2 million units once a day for 10 days. In a similar concentration, the novocaine salt of penicillin is also introduced, it is used for 28 days. At the end of the course, a 14-day break is observed, and the two-week injection scheme begins again.

If the patient has lesions of internal organs caused by syphilis, treatment is carried out according to a different system. The general scheme is determined together with, and in complex cases, other, narrower specialists are also involved.

The first requirement of such treatment is the implementation of preparatory therapy. The patient is administered 0.5 g of Tetracycline or Erythromycin 4 times a day for 14 days daily. When the preparation is over, the patient is transferred to a 28-day course of Penicillin - injections should be done 8 times a day, every three hours. The dosage of the substance is 400 thousand at a time. At the end of this period, you need to wait a two-week break, after which a similar course of treatment is carried out again, but within 14-20 days.

Procaine-penicillin is administered to the patient in doses of 1.2 million units, once a day, for 42 days. After a pause of two weeks, the therapy is repeated for 14 days.

The treatment of neurosyphilis requires a slightly different approach. In the process of drawing up a treatment plan, not only a venereologist and a therapist are involved, but also with.

An effective remedy in this case is the sodium salt of benzylpenicillin. It is administered to the patient in a dosage of 10 million units with an hour and a half dropper. The procedure is carried out twice a day for two weeks. In addition, a solution of penicillin is injected intravenously 6 times a day.

The control of treatment of tertiary syphilis implies a mandatory chemical examination of the cerebrospinal fluid 6 months after completion of therapy.

Late neurosyphilis is treated according to a similar scheme, but antibiotic therapy is carried out twice.

If gummy nodules are found in the spinal cord or brain, the patient is also shown a two-week intake of Prednisolone.

Such schemes are successfully used to treat adults, pregnant women, and the elderly.

As for children, tertiary and advanced syphilis is treated with Bicillin-3, Bicillin-5, Penicillin. Preparatory therapy is Bioquinol.

Concomitant methods of treating syphilis in late and advanced cases are the most relevant - patients are prescribed immunomodulators, pyrotherapy, hormonal drugs.

After all the therapeutic measures taken, the patient must pass control serological tests, and over the next five years, tests must be taken every six months. All this time, those who have been ill with advanced syphilis are registered in the KVD.

Additional preventive measures and surgery after completion of treatment

Syphilis is a very insidious disease, since in its course there is a characteristic variety of symptoms, which is sometimes replaced by latent periods. Therefore, even if the patient has the disappearance of the disease in the test results, he is still put under clinical control and registration by a venereologist. In order for the doctor to periodically check for the presence of antibodies in the blood, a person must periodically take appropriate tests. The presence of syphilis pathogens in the blood after treatment is an alarming sign that indicates that penicillin therapy should be continued.

In cases where the activity of pale treponema in the body is suppressed, but the negativity of serological processes in the blood occurs too slowly, the patient may develop seroresistant or latent syphilis - this occurs in about 5-6% of cases of treatment. Seroresistance is due to fundamental changes in humoral and cellular immunity, while the number of T- and B-lymphocytes, as well as class M immunoglobulins, decreases in the patient. Therapeutic plasmapheresis increases the level of specific antibodies by 1.5 times. Thanks to this prevention of recurrence of syphilis, seropositive reactions should disappear in 60% of patients after the procedure.

A more thorough method of intervention after the end of syphilis treatment is surgical. Syphilis becomes the reason for the appointment of an operation in such cases:

• with deformation of the stomach;
• with stenosis;
• if the defeat of syphilis is combined with cancerous tumors;
• in the presence of gummy ulcers with infiltrate in the cavities of internal organs or in the mouth;
• with curvature of bones, syphilitic lesions of the joints;
• with the appearance of deformations of the maxillofacial part of the skull, confluence of the nose, destruction of the tissues of the lips.

Traditional medicine against syphilis

Is it possible to treat syphilis on your own at home? The unequivocal answer is no. This disease with a large number of symptoms can periodically become chronic. In addition, the consequences of syphilis can not only disfigure the patient, but also make him disabled or even lead to death. Such a disease requires constant clinical monitoring, observation by a qualified venereologist and strict implementation of all medical prescriptions, otherwise there is a high probability of the formation of new lesions of body tissues, as well as the reappearance of the disease after a latent period. At the same time, traditional medicine recipes can only be used as additional measures for the general strengthening of the body and only in agreement with the doctor.

For example, common recipes are products with and. To prepare a remedy, you need to mix 200 grams with 100 milliliters. The mixture is brought to a boil, then 400 grams of warm red wine are added to it and. The product is stirred, cooled, after which 7-8 crushed garlic cloves are put into it and left to infuse for 3 hours. After straining, the drink is drunk daily at 100 grams.

Burdock root treatment consists in the use of a special decoction. To prepare it, take 200 milliliters of water, add 1 tablespoon of chopped burdock root to it. After boiling the mixture for 20 minutes, it is filtered, after which the remedy is taken daily, 1 tablespoon.

There are also methods for treating lesions with hops, various herbal preparations, and sand sedge root.

How can all these remedies affect the course of recovery? Basically, they have only a general stimulating and strengthening effect. As for the impact on the causative agent of syphilis, doctors and specialists in their reviews convince patients not to rely on it, but to immediately contact a doctor to develop an adequate treatment.

What to do if there are signs of syphilis development

Having found symptoms of the disease (hard chancre, inflammation of the lymph nodes, feverish condition, characteristic of the body), you should immediately seek medical help.

Which doctor should you visit? An initial examination can be carried out by a therapist. Next, he should refer the patient to a venereologist, urologist

Speciality: pediatrician, infectious disease specialist, allergist-immunologist.

General experience: 7 years .

Education:2010, Siberian State Medical University, pediatric, pediatrics.

Over 3 years of experience as an infectious disease specialist.

He has a patent on the topic "Method for predicting a high risk of developing chronic pathology of the adeno-tonsillar system in frequently ill children." And also the author of publications in VAK magazines.