Syphilis treatments

Updated on:
February 16, 2022

Are there currently treatments available for syphilis?

Yes, syphilis can easily be treated through a shot of an antibiotic called penicillin. The exact dose usually depends on how long you’re estimated to have had the infection for.

What are the post-exposure treatment options for syphilis?

The most common antibiotic used to treat syphilis is benzathine penicillin G. A dose involving two injections is usually needed for cases diagnosed within a year of infection. Higher doses are needed for those who’ve had syphilis for longer or are pregnant. Injections are usually administered into the buttocks muscle.

An alternative antibiotic called doxycycline can also be used in patients who are allergic to penicillin. The effectiveness of doxycycline treatment can be lower for people with a severely weakened immune system. This medication can not be used in pregnancy.

Some providers may choose to supervise tiny, but gradual, doses of penicillin to patients who are pregnant and allergic to the medicine, which would allow them to eventually be able to tolerate a complete penicillin dose.

Other antibiotics, such as azithromycin and ceftriaxone, are not recommended for treatment of syphilis due to high rates of treatment failure.

Are some treatments more accessible than others?

The recommended and most commonly delivered course of treatment in Canada is benzathine penicillin G. However, getting a dose may require being seen at a specific clinic as it is not available or administered at all clinics or pharmacies.

When should I begin post-exposure treatment for syphilis?

Treatment for syphilis should happen as soon as a diagnosis is made. When an STI is treated early, it decreases its impacts on your body and prevents further transmission.

If left untreated, syphilis can progress in the body from primary, secondary, to tertiary stages. It’s important to ensure testing and treatment happen as soon as possible after a possible exposure to the infection.

Once a syphilis case has been confirmed, your provider will contact you to discuss treatment, partner notification, or the need for further testing.

Getting a treatment for syphilis

Where can I get treatment for syphilis?

Syphilis treatment can be accessed in medical and clinical settings like STI clinics and a doctors’ office.

Is it discreet?

Syphilis treatment is discrete. Nobody besides your provider and public health nurse will know about your diagnosis. You will likely need to report any partners who you may have exposed to syphilis, but the contact tracing is done by medical providers without releasing any personal information about you.

How much does it cost?

In Canada, treatment is free for anyone with a valid healthcare card. Compassionate coverage for those without healthcare is often offered by sexual health clinics but not guaranteed.

Can I have sex during and/or after my treatment for syphilis?

After being diagnosed and treated for syphilis, you can have sex again once treatment has completely cured the infection (see below).

Do you have to wait to have sex? For how long?

You should wait 7 days after completing treatment before having sex again. If you have lesions or rashes, you should wait until any associated symptoms stop before having sex again.

What are the risks to my partners if I don’t wait?

Not waiting for the treatment to take effect will mean that you can still transmit syphilis to partners who might be able to give it back to you, meaning you both might need to repeat the treatment.

Do I need to communicate this to my partners? If I choose to, how should I?

It’s important to have honest and open communication with your partners about your sexual health, STI, and testing history. If you haven’t been tested in a long time, have any symptoms, or have untreated syphilis, it’s important to tell your partners.

If you’ve been medically advised that your syphilis infection has been treated and that you can no longer transmit the infection, it’s your choice whether or not to tell your partner about any of your diagnoses. It’s important to note that, although treatment cures syphilis and ensures you cannot pass it on, it does not prevent you from getting syphilis in the future.

How can I be sure the treatment for syphilis worked?

Once you’re finished with your antibiotic treatment, you may be asked to go for a follow-up blood-test to ensure the infection is gone. It’s important to follow the instructions of a healthcare provider about treatment and follow-up visits.

Will any symptoms cease to exist?

Treatment ensures your body is cured from the infection and any associated symptoms.

What do you do if the treatment doesn’t work?

If you suspect treatment has not cured the infection, and/or if symptoms persist, it is important to speak to a healthcare provider as soon as possible.

Reviewed by:
Dr. Caley Shukalek

Caley is passionate about evidence-based, patient-centred care, including telemedicine that can provide high quality care from wherever a patient may choose.

He helped create Alberta's PrEP guidelines and works as a specialist in General Internal Medicine with additional training in sexual health, including HIV and sexually transmitted infections.

He holds an Masters of Public Health from Johns Hopkins University, an MD from the University of Calgary and an MSc from the University of Alberta.