Pharmacotherapeutics of Syphilis

1. Dr.V. S. Swathi
Assistant Professor

2.  Syphilis is caused by the spirochete
Treponema pallidum and is characterised by
three sequential clinical, symptomatic
stages separated by periods of
asymptomatic latent infections.

3.  Each year, there are an estimated 6 million
new cases of syphilis globally in persons
aged 15-49 years
 In 2015, syphilis cases found in India were
30,000 approximately

4. PrimarySyphilis
 It appears after 10-90 days of infection
 one or more small painless sores appears in or around the genitals,
anus and mouth
Secondary Syphilis
 It appears 2-8 weeks after infection
 It affects circulatory and lymphatic system
Latent Syphilis
 It appears after 4-10 weeks after infection
 In this stage patient does not show any symptoms
 Microbes will spread all over the body
Tertiary Syphilis
 It appears after 10-30 years after infection
 In this stage brain, heart, eyes, bones and joints are affected

5.  Persons having unprotected sex
 HIV patients
 Persons with multiple sex partners
 Unborn babies of mothers who are having
Syphilis

6.  It is caused by bacterium called Treponema
pallidum
 It is mostly transmitted by sexual
intercourse with affected patients with
Syphilis
 It can also transmitted to baby by mother
with Syphilis
 Occasionally it is transmitted through
contact with lesions of infected patients
and through blood transfusions

9. Primary Syphilis
 Chancres on skin
Secondary Syphilis
 Number of mucocutaneous eruptions
 Malaise
 Fever
 Pharyngitis
 Headache
 Anorexia
 Arthralgia

10. Latent Syphilis- Asymptomatic
Tertiary Syphilis:
Neurosyphilis
 Severe headache
 Difficulty in coordinating muscle movements
 Paralysis
 Numbness
 Dementia
Ocular Syphilis
 Blurred division
 Blindness

11.  Neurosyphilis
 Ocular syphilis
 Cardiovascular syphilis
 Congenital syphilis
 Joint/ bone syphilis

12.  Microscopic examination of serous material
from a suspected syphilis lesion
 Direct fluorescent antibody test for
Treponema pallidum (DFA-TP)
 Venereal disease research laboratory test
(VDRL) slide test
 Rapid plasma regain (RPR) card test
 Unheated serum reagin (USR) test
 Toludene red unheated serum test (TRUST)
 PCR test

14.  Counselling to avoid unprotected sex,
having multiple sex partners
 Take proper measures to keep environment
hygienic

16. Drug Category Mode of action Dose Adverse effects
Benzathine
Penicillin G
Penicillin Inhibit bacterial
cell wall
synthesis
2.4 million
units once
weekly- IM
 Skin rashes
 Urticaria
 Serum sickness reactions
 Jarisch- Harxheimer
reaction
 Pseudomembranous colitis
Aqueous
procaine
penicillin
Penicillin Inhibit bacterial
cell wall
synthesis
2.4 million
units once
daily- IM
for 10-14
days with
Probenacid
 Skin rashes
 Urticaria
 Serum sickness reactions
 Jarisch- Harxheimer
reaction
 Pseudomembranous colitis
Aqueous
crystalline
penicillin
Penicillin Inhibit bacterial
cell wall
synthesis
18-24
million
units once
daily- IM
for 10-14
days
 Seizures
 Anaemia
 Interstitial nephritis
 Jarisch- Harxheimer
reaction
 Hypersensitivity

17. Ceftrioxone Cephalosporin Inhibit bacterial
cell wall synthesis
1-2g-IM/ IV
four times for
28 days
 Eosinophilia
 Thrombocytosis
 Diarrhoea
 Hepatotoxicity
 Nephrotoxicity
Tetracycline Tetracycline Inhibit bacterial
protein synthesis
500mg- four
times orally
for 14-28 days
 Epigastric distress
 Teeth discoloration
 Photosensitivity
 Nephrotoxicity
 Hepatotoxicity
Doxycycline Tetracycline Inhibit bacterial
protein synthesis
100mg-twice
daily for 14
days
 Anorexia
 Tooth discoloration
 Diarrhoea
 Dysphagia
 Enterocolitis
Probenacid Uricosuric agent Along with
penicillin it
increases penicillin
levels in body by
inhibiting tubular
secretion of
penicillin
500mg- four
times- orally
for 10-14 days
along with Aq.
Procaine
Penicillin
 Anaemia
 Leucopoenia
 Renal calculi
 Exacerbation of gout
 Gouty Arthralgia

18.  https://www.ncbi.nlm.nih.gov/pmc/articles
/PMC5434955/
 http://www.neurologyindia.com/text.asp?
2016/64/7/131/178060
 http://www.ijmm.org/text.asp?2016/34/1/1
11/167674
 https://doi.org/10.1016/j.ijgo.2015.04.014
 https://www.ncbi.nlm.nih.gov/pmc/articles
/PMC4386224/