What is the first-line treatment for syphilis?

Benzathine penicillin G is recognized as the first-line treatment for syphilis for several important reasons. Syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum, has distinct stages, and penicillin has proven to be effective against all of them, including primary, secondary, and latent syphilis.

The efficacy of benzathine penicillin G lies not only in its ability to eliminate the bacteria but also in its long-acting formulation, which allows for a single intramuscular injection to provide lasting therapeutic effects. This makes it especially convenient in clinical practice, ensuring a high rate of adherence to therapy.

Other treatments, while potentially effective in certain situations, do not meet the same standards for first-line therapy. Doxycycline can be used as an alternative for patients allergic to penicillin or in cases where penicillin is contraindicated, but it requires a longer treatment duration of 14 days, which may impact adherence. Azithromycin has been used in the past, but growing resistance issues have led to decreased effectiveness, making it less preferable. Cephalexin, a cephalosporin antibiotic, is not indicated for the treatment of syphilis at all, as it does