Barrett-Connor E
West J Med. 1975 Jan;122(1):7-11.
Penicillin remains the treatment of choice for syphilis, with sustained low blood levels curing virtually all patients having early syphilis and halting disease progression in most patients with symptomatic syphilis. Tetracycline, erythromycin or cephalothin yields similar cure rates for patients with early syphilis who are allergic to penicillin. The efficacy of non-penicillin regimens for the treatment of late syphilis is uncertain. Results of Venereal Disease Research Laboratory (VDRL) or other reagin tests should become negative or remain at very low titer following adequate therapy, although results of Treponema pallidum immobilization (TPI) and fluorescent treponemal antibody-absorbed (FTA-ABS) tests often remain positive.
青霉素仍然是梅毒治疗的首选药物,持续的低血药浓度实际上可治愈所有早期梅毒患者,并使大多数有症状的梅毒患者病情停止进展。对于对青霉素过敏的早期梅毒患者,四环素、红霉素或头孢菌素的治愈率相似。非青霉素治疗方案对晚期梅毒的疗效尚不确定。经过充分治疗后,性病研究实验室(VDRL)或其他反应素试验的结果应转为阴性或维持在非常低的滴度,尽管梅毒螺旋体制动(TPI)试验和荧光螺旋体抗体吸收(FTA-ABS)试验的结果通常仍为阳性。