Syphilis drugs

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... 

Parenteral penicillin is the drug of choice for all stages of syphilis. 

Parenterally administered penicillin is recommended for all stages of syphilis. Alternative agents may be used in allergic individuals and include doxycycline, minocycline, tetracycline, or erythromycin base or stearate. Some patients may not respond favorably to alternative modalities. Therefore, in patients who must be administered penicillin (i.e., patients who are pregnant or have central nervous system [CNS] involvement) or are allergic, desensitization must be performed before the drug is initiated. 

Drug of choice Benzathine penicillin G 2.4 million units or 7.2 million units intramuscularly over 3 weeks if the duration of syphilis has been at least a year... 

This compound was found to be effective in treating syphilis and African sleeping sickness, although more effective drugs soon became available. In addition to the name Salvarsan, this compound is listed in the Handbook of Chemistry and Physics as "606" to denote where it fell in the series of compounds tested by Ehrlich and his collaborators. 

It should not be assumed that all birth defects and functional abnormalities in children are caused by drugs or environmental chemicals. It is clear that environmental factors such as extreme heat or cold, certain forms of radiation, infections (particularly German measles and syphilis), dietary deficiencies, and genetic disorders in the parents can all put the developing fetus at risk. 

Bismuth, discovered in 1753, has a long history of medical uses ranging from treatment of syphilis and malaria to diarrhea. More recently, antibacterial properties of bismuth-containing antacids have been used to treat peptic ulcers. In general the medical use of bismuth has declined with the advent of new drug therapies. 

A) Ehrlich discovering the drug salvarsan for the treatment of syphilis... 

B. The patient is pregnant and has latent syphilis of indeterminate duration. The pathogenic organism is T. pallidum. Benzathine penicillin G is the drug of first choice for treating latent syphilis. Doxycycline and tetracycline are alternatives treatments for nonpregnant patients with latent syphilis. 

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. 

---