Syphilis: antibiotic treatment and resistance

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Syphilis is a chronic, multi-stage infectious disease transmitted sexually or congenitally.
• It is endemic in developing nations and re-emerging in developed countries.
• Syphilis increases the risk of human immunodeficiency virus (HIV) acquisition and transmission.

Purpose of the Study:

• To review the diagnosis and recommended antibiotic treatment of syphilis.
• To highlight the challenge posed by macrolide-resistant Treponema pallidum subspecies pallidum.

Main Methods:

• Review of current literature on syphilis diagnosis and treatment.
• Analysis of the impact of antibiotic resistance on syphilis management.

Main Results:

• Penicillin G remains the first-line treatment for all stages of syphilis.
• Clinically significant azithromycin resistance in Treponema pallidum has led to treatment failures.
• Routine use of azithromycin as a second-line drug is now precluded.

Conclusions:

• Effective syphilis control relies on identification and treatment of infected individuals and their contacts.
• The emergence of macrolide resistance necessitates careful consideration of antibiotic choices.
• Ongoing surveillance and research are crucial for combating syphilis resurgence and antibiotic resistance.