Syphilis treatment varies according to the type and scope diagnosed. Syphilis is a sexually transmitted disease (STD) that may have varied and subtle physical symptoms. Primary syphilis usually manifests in a single painless chancre. Secondary syphilis, however, may include varied symptoms, such as fever, inflamed lymph nodes, rash, and a genital moist growth. Manifestations subside in secondary syphilis, and infection is only apparent through testing.
Latent syphilis may manifest years later as a central nervous disorder or cardiovascular disease. The most common treatment for syphilis is various forms of penicillin. There are also alternative medicine regimens for patients who are either intolerant to penicillin or for whom the medication is not advised.
Penicillin
According to the Centers for Disease Control and Prevention (CDC) penicillin is the most commonly prescribed treatment for those diagnosed with syphilis. Originally, penicillin was considered an effective syphilis treatment for syphilis before its widespread use after clinical trials.
The treatment guidelines by the CDC are largely based upon expert opinions and trials that were uncontrolled. Guidelines are further based upon the various stages of the illness. Due to a slower bacterial replication rate, the later stages of syphilis required longer courses of treatment.
Regardless of potential allergic or other reactions, penicillin has remained the consistent standard mainstay and treatment by which all of the other therapies are routinely judged. The 2010 CDC STD treatment guidelines continue to support penicillin’s use as the most effective, and therefore, preferred medicine for treating every syphilis state. 
For example, penicillin is the still the only therapy widely prescribed for congenital syphilis and neurosyphilis, as during pregnancy. On very rare occasions, the T pallidum organism present in syphilis has persisted, despite following a penicillin regimen therapy. Despite that, however, there is no indication that a resistance to penicillin has been acquired by this organism.
Primary and Secondary Syphilis Treatment
Primary syphilis is generally treated by administering a single does of 2.4 million units of penicillin G benzathine, delivered intramuscularly. At the six and 12 month marks after treatment commences, patients are reexamined and tested. Treatment failure results in patients being tested for HIV infections as well as an evaluation for neurosyphilis and a cerebrospinal fluid exam.
Alternative Treatments
Non-pregnant patients with penicillin sensitivity are given a dose of 100 mg of doxycycline (Vibramycin) for two weeks, orally twice each day. Alternatively, they may be given a 500 mg dose tetracycline, for two weeks, iorally four times a day.
Another alternative medicine for syphilis is ceftriaxone (Rocephin), at 1 g dose, delivered intravenously or intramuscularly, once a day for 8-10 days. Azithromycin (Zithromax) is another medicine that may also be administered in single 2-g doses orally, also for 8-10 days.
Allergies
Prior to dispensing penicillin for syphilis. patients with suspected allergies are first given a skin allergy test. Subsequently, patients are administered a form of penicillin desensitization, if it is determined that it is necessary. The 2010 CDC STD syphilis treatment guidelines also recommend that pregnant women receive the desensitization treatment followed by penicillin treatment.
Syphilis and HIV
According to the 2010 CDC STD treatment for syphilis guidelines, no regimens have ever been shown to be as, or more effective in preventing neurosyphilis in HIV positive patients than that which is prescribed for patients who are HIV negative.
In every case, the CDC recommends continual and careful monitoring of all therapies required and given with regard to syphilis treatment.