What is the treatment of choice for syphilis?

Benzathine penicillin G is the treatment of choice for syphilis due to its effectiveness and targeted action against the Treponema pallidum bacterium, which causes the infection. The single intramuscular dose of 2.4 million units provides a sustained release of penicillin that helps eradicate the spirochete over an extended period, which is crucial in managing not just early syphilis but also preventing the progression to late complications.

Other treatment options, while they may show efficacy in certain contexts, do not hold the same level of effectiveness or recommendation for syphilis treatment. Tetracyclines, for instance, can be used in penicillin-allergic patients or in specific cases but are not the first-line treatment due to concerns about resistance and gastrointestinal side effects. Ceftriaxone may be effective in atypical cases or co-infections but again is not the standard for treating primary syphilis. Azithromycin has been explored as an alternative in specific situations, but there have been concerns about its reliability and treatment failure, making it unsuitable as the first-line option. Benzathine penicillin G remains the cornerstone of therapeutic management for syphilis, endorsed by guidelines from health organizations and comprovoked by its