What is the standard treatment for syphilis?

• A. Doxycycline
• B. Penicillin G
• C. Acyclovir
• D. Ceftriaxone

Answer: (B)

Penicillin G is the standard treatment for syphilis because Treponema pallidum remains highly susceptible to penicillin and penicillin achieves the necessary tissue and CNS penetration to eradicate the organism across all stages. For early syphilis, a single intramuscular dose of benzathine penicillin G 2.4 million units is typically sufficient. For late latent or unknown duration, the regimen is 2.4 million units IM once weekly for three weeks. If neurosyphilis or ocular syphilis is suspected, high-dose intravenous penicillin G totaling 18–24 million units per day is given, usually every four hours or as a continuous infusion for 10–14 days. In pregnancy, penicillin G remains the preferred and safest option, with alternatives like doxycycline avoided due to safety concerns. Other drugs such as doxycycline or ceftriaxone can be considered in specific penicillin-allergic cases or certain scenarios, but they are not the standard first-line therapy.