Syphilis antibiotics

Spectinomycin is not effective in the treatment of syphilis. Antibiotics used to treat gonorrhea may mask or delay the symptoms of incubating syphilis. All patients with gonorrhea should have a serologic test for syphilis at the time of diagnosis and a follow-up test after 3 months. 

Penicillin desensitization is the most common drug desensitization protocol and is required for penicillin-allergic patients when penicillin is clearly the best treatment option, e.g., when syphilis is present in pregnancy. Protocols have been adapted to most antibiotics. Tables 51-5 and 51-6 describe procedures for oral and intravenous penicillin desensitization.25... 

As long as no evidence of CNS involvement exists, antibiotic therapy for gummatous and cardiovascular syphilis is identical to that for tertiary syphilis. 

The argument is often made that African Americans and other ethnic minorities do not participate in clinical trials because they do not want to. African Americans in particular were thought to be suspicious of participation because of previous experiences of exploitation and manhandling of vulnerable minority groups (Melfi et al, 2000 Corbie-Smith et al, 1999). The Tusgekee syphilis study is often cited as a reason for mistrust (Shavers et al, 2000 Shavers et al, 2002 Corbie-Smith et al, 1999). This study was a federally funded study of the long-term consequences of syphilis on African American men initially started before antibiotics were available. 

At the beginning of the twentieth century, arsenic compounds were used to kill spirochete bacteria, which cause the sexually transmitted disease syphilis. After this amphetamine compound was used to treat syphilis in Europe, the disease rate was reduced by more than half. The antibiotic penicillin has replaced arsenic for most medical purposes... 

People long ago recognized that, depending on the dose, arsenic could either treat an illness or be used as a poison to cause death. Its medicinal use to treat syphilis and amebic dysentery ended with the introduction of penicillin and other antibiotics in the twentieth century. Arsenic-based compounds are currently used to treat some forms of cancer. As a poison, arsenic trioxide (As20 ) has several desirable qualities it looks like sugar, it is tasteless, and it only takes about a tenth of gram to kill some-... 

Erythromycin is effective in the treatment and prevention of S. pyogenes and other streptococcal infections, but not those caused by the more resistant fecal streptococci. Staphylococci are generally susceptible to erythromycin, so this antibiotic is a suitable alternative drug for the penicillin-hypersensitive individual. It is a second-line drug for the treatment of gonorrhea and syphilis. Although erythromycin is popular for the treatment of middle ear and sinus infections, including H. influenzae, possible erythromycin-resistant S. pneumoniae is a concern. 

Of historical interest, arsenical antibiotics (8.107) were once used to treat syphilis and mercurial diuretics (8.108) were once used to treat edema and to promote water excretion. Due to their high toxicity, neither is currently used. 

Penicillin was first used in 1941 as an antibiotic. Because of its low toxicity, it was called a miracle drug. It was used in infections such as staphylococcus, streptococcus, pneumococcus, meningococcus, gonorrhea, syphilis, diphtheria, and tetanus. Furthermore, penicillin also has prophylactic uses for some diseases. 

Some experts recommend multiple doses of benzathine penicillin C or other supplemental antibiotics in addition to benzathine penicillin C in HIV-infected patients with primary or secondary syphilis, HIV-infected patients with early latent syphilis should be treated with the recommended regimen for latent syphilis of more than I -year s duration. 

In the 1930s and 1940s, bismuth formulations were used extensively to treat syphilis, but they have since been supplanted by more effective antibiotics. More recently, bismuth complexes have been examined for antitumor activity, 64 Tiekink compared the literature results for antimony(III), anti-mony(V), and bismuth(III) with the conclusion that Bi(III) was most promising among these possibilities. ... 

Because Treponema pallidum is sensitive to penicillin G, this antibiotic is the drug of choice for treatment of syphilis and syphilitic eye disease (see Table 11-1). Syphilitic eye disease can include interstitial keratitis (stromal inflammation and vascularization), episcleritis, scleritis, nongranulomatous or granulomatous iritis, iris papules (collections of dilated capillaries in the iris), chorioretinitis, papillitis, retinal vasculitis, and exudative retinal detachment. Probenecid can be added to procaine penicillin to decrease excretion of the penicillin by the kidneys, thus causing an increase in penicillin plasma levels. Penicillins are not used for the treatment of minor ocular infections such as blepharitis and conjimctivitis... 

Arsphenamin was the first drug substance with thermotropic mesomorphism to be therapeutically used as Salvarsan during the first half of the nineteenth century. The drug is effective against microorganisms and thus offered for the first time an efficient therapy of veneral diseases such as syphilis. Nowadays, it has been replaced by antibiotics with less serious side effects. 

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