Syphilis therapy

The treatment of choice for syphilis is the antibiotic penicillin (benzathine benzylpenicillin), which is administered as an injection into the gluteal muscle.

Procedure of the therapy

In the case of neurosyphilis, we administer penicillin intravenously for two weeks. The USZ now offers this intravenous therapy via a portable antibiotic pump, so that the treatment can be carried out on an outpatient basis from home and the affected person does not have to be hospitalized. To avoid further infection, your partner or sexual partners from the last 90 days should also be treated. If there is an allergy to penicillin, we can switch to antibiotics with other active ingredients such as doxycycline. We know from our own investigations that the macrolide antibiotics that were previously recommended as an alternative can no longer be used due to resistance.

Dose and duration of therapy

The exact dose and duration of therapy depends on the stage of the disease. The so-called Herxheimer reaction can occur at the start of antibiotic therapy, particularly in the case of longstanding syphilis. The mass death of the bacteria releases cell toxins (endotoxins), which can lead to flu-like symptoms such as fever, chills, headaches or muscle aches. This can be avoided by administering a cortisone preparation before the first course of antibiotics.

Responsible doctor

Philipp Bosshard, PD Dr. sc. nat.

Senior Scientist, Department of Dermatology

Tel. +41 44 255 39 72

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