Syphilis Treatment and Care
Syphilis can be cured with the right antibiotics. However, treatment will not undo any damage that the infection has already caused.
What is the treatment for syphilis?
There are no home remedies or over-the-counter drugs that will cure syphilis, but syphilis is easy to cure in its early stages. A single intramuscular injection of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) will cure a person who has primary, secondary or early latent syphilis. Three doses of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) at weekly intervals is recommended for individuals with late latent syphilis or latent syphilis of unknown duration. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.
Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis. Combinations of some penicillin preparations (e.g., Bicillin C-R, a combination of benzathine penicillin and procaine penicillin) are not appropriate treatments for syphilis, as these combinations provide inadequate doses of penicillin.
Although data to support the use of alternatives to penicillin is limited, options for non-pregnant patients who are allergic to penicillin may include doxycycline, tetracycline, and for neurosyphilis, potentially probenecid. These therapies should be used only in conjunction with close clinical and laboratory follow-up to ensure appropriate serological response and cure.
Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.
Treatment Guidelines and Updates
- Clinical Advisory: Ocular Syphilis in the United States (Updated April 16, 2015)
- 2010 STD Treatment Guidelines - Syphilis - information regarding the emergence of azithromycin-resistant Treponema pallidum and the criteria for spinal fluid examination to evaluate for neurosyphilis (December 16, 2010)
Resources for Clinicians
- Updated Syphilis Clinical Training (August 30, 2013)
- Doxycycline and Tetracycline Shortage Update (March 1, 2013)
- Page last reviewed: April 28, 2010
- Page last updated: April 17, 2015
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