Syphilis is a method of infection and preventive measures. Prevention of syphilis - all possible ways to avoid infection

Reasons for the development of syphilis

The main route of infection with syphilis is sexual, less common is household. There is also a vertical route of infection: from mother to fetus, it is characteristic of congenital syphilis.

The highest incidence of syphilis is observed between the ages of 20 and 29 years. IN last years Syphilitic infection is more common than before in children and adolescents.

Primary syphilis is slightly more common in men than in women. At the same time, secondary and latent syphilis is more often recorded in women.

Man as a cause of syphilis infection

What types of treatment for syphilis exist today?

There are several types of treatment for syphilis:

• Specific. Once the diagnosis is made, treatment is carried out with antibiotics. But since they kill not only harmful ones, but also beneficial microbes, then vitamins and drugs that increase immune protection body.
• Preventive. It is prescribed to persons who have been in contact with a patient with syphilis during the infectious stage of the disease.
• Preventive. Applicable to pregnant women who have previously had syphilis or have this disease in their this moment. And also to children whose mothers were infected during pregnancy.
• Trial. Prescribed if a specific lesion is suspected internal organs if it is not possible to confirm the diagnosis with convincing laboratory data.
• Epidemiological or syndromic. It is carried out on the basis of anamnesis and clinical picture in the complete absence of the possibility of carrying out laboratory diagnostics.

How is syphilis treated in the early stages?

What medications are used to treat syphilis? early stages? Treatment of primary and secondary syphilis carried out using the same methods. Therapy involves a course of antibiotics for 2 weeks.

After it is entered high dose long-acting penicillin. 30 minutes before the injection, a suprastin or tavegil tablet is given.

There are some other treatment regimens. But they are all selected individually. The most popular scheme treatment - prescription of penicillin drugs long acting. Injections are given once a week. In the early stages, syphilis responds well to treatment, so 1 to 3 injections are sufficient.

Skin rashes that begin in the second stage of the disease are treated with chlorhexidine with penicillin dissolved in saline solution. Repeat the lotions until the rash disappears completely.

For faster resorption of hard chancre, they are lubricated with heparin ointment or a special mixture of podophyllin, dimethyl sulfoxide and glycerin.

For more fast healing sores on the body are irradiated with a helium-neon laser. They cauterize each rash for 10 minutes daily. The course of treatment is 14 days.

Symptoms of syphilis

The causative agent of syphilis is a bacterium that is difficult to see under a microscope even when staining the biological samples under study. Therefore, in medicine it received the name pale treponema.

There are congenital syphilis (develops when the fetus is infected) during pregnancy, domestic syphilis (when infected from objects common use), sexual (during sexual intercourse with an infected person).

Laboratory diagnostics

Methods for laboratory diagnosis of syphilis have great importance to establish a diagnosis, especially in the latent form.

To understand the principle and effectiveness of a particular method, it is necessary to distinguish between the concepts of its specificity and sensitivity. In medicine, sensitivity is understood as the percentage of cases in which a disease will be detected and the percentage of pathology that may remain undiagnosed.

Good sensitivity is considered to be 90% or higher. For example, with a method sensitivity of 80%, 20% of cases may remain undetected.

The specificity of the method shows the percentage of positive reactions that confirms the disease. For example, a specificity of 70% indicates that 30% of reactions are false positives. Sufficient specificity ranges from 90 to 100%.

What laboratory diagnostic methods are used for syphilis?

Indirect laboratory diagnostic methods detect the presence of antibodies in the patient’s blood:

1. The Wasserman reaction (RW) with cardiolipin antigen was used recently as a screening method, but in recent years it has not been used due to insufficient sensitivity (with syphilis, negative RW is possible in 20% of cases), as well as due to the high percentage of false-positive reactions ( thirty%). Currently replaced by the microprecipitation reaction, but out of habit it is sometimes called the RW reaction.
2. The microprecipitation reaction (PM) with cardiolipin antigen has a high specificity (98%), with primary syphilis a positive reaction is observed in 91% of cases. The microprecipitation reaction is also performed with treponemal antigen.
3. To detect antibodies to Treponema pallidum, RPHA has high specificity (in 99% of cases, a positive reaction indicates the presence of syphilis), but its sensitivity is low (according to scientific data, 76% of cases of the disease can be detected in this way).
4. Highly sensitive indirect methods with a specificity of about 100% - RIF (immunofluorescence reaction), ELISA ( linked immunosorbent assay), RIBT (treponema pallidum immobilization reaction).

How to treat syphilis?

Bacteria that infect humans are sensitive to antibiotic drugs. They are the ones prescribed to the patient. As a rule, these are penicillins. However, patients often complain of allergic sensitivity to the drugs presented.

In this case, macrolides, fluoroquinolones, and tetracyclines can be used. Also, these medications are used in case of ineffectiveness of penicillin therapy.

The list of antibiotics for syphilis is:

• retarpen;
• bicillin;
• tetracyclines;
• extensillin;
• sumamed;
• ampicillin;
• erythromycin;
• doxycycline.

Along with the presented therapy, vitamins and medications that increase protective properties body. It is possible to administer immunostimulants - intramuscular injections.

Immune medications include: laferon, thymogen, methyluracil, thymalin. And stimulant drugs are plasmol and pyrogenal.

For achievement best effect When treating syphilis, physiotherapy is prescribed.

1. Inductothermy

Inductothermy is a type of electrotherapy. The technique is based on the use of high-frequency magnetic field. In patients with syphilis, it is recommended to use inductothermy.

Preventive (warning) treatment is carried out to persons who have been on lumbar region and combine with taking the drug central action Etimizole. The drug Etimizol acts on the pituitary gland, which leads to an increase in glucocorticosteroids in the blood plasma.

2. Magnetic therapy

As I said above, during the period of bearing a child, syphilis is very dangerous.

Prevention of this disease is carried out in all medical institutions and includes the following measures:

1. 1. All patients in general somatic hospitals are examined for the presence of this disease for the purpose of its early detection.
2. Patients among human donors are identified in order to prevent transfusion syphilis.
3. All pregnant women must be examined twice in the first two trimesters to prevent congenital disease.
4. All patients are subject to compulsory treatment, and imperfect and unadapted people with severe course illnesses are necessarily hospitalized.
5. Sanitary education work is being carried out to convey information about the disease to the masses.

The microbe enters the child's body through umbilical vein, as well as through the placenta, starting from the 10th week of pregnancy. When a woman has secondary syphilis, infection will occur in 100% of cases. In rare cases, children become infected in patients suffering from primary or late forms of the disease.

Treatment occurs under the supervision of a doctor, often in a hospital, and includes all the same measures that are prescribed for other patients. Antibiotics are selected with great care so as not to cause pathologies and abnormalities.

Currently, with timely treatment of syphilis, it is always observed favorable outcome. As a rule, antibiotic therapy is used to suppress the development of Treponema pallidum, the causative agent of this disease, and to free the body from it.

Treatment methods for syphilis infection

Specific treatment prescribed to the patient after diagnosis. The diagnosis is established on the basis of appropriate clinical manifestations, detection of the causative agent of the disease and the results of serological examination (RSC, MRP (or analogues - VDRL, RPR), RPGA, ELISA, RIF, RIBT).

Methods of preventive treatment of syphilis

Preventive therapy Persons who have had sexual or close household contact with patients with early stages of syphilis are subject to this if no more than 2 months have passed since the contact.

Persons in whom 2 to 4 months have passed since contact with a patient with syphilis undergo a double clinical and serological examination with an interval of 2 months. If more than 4 months have passed since contact, a one-time clinical and serological examination is performed. Preventive treatment of syphilis in a recipient who has received a blood transfusion from a patient with syphilis is carried out according to one of the methods recommended for the treatment of primary syphilis, if no more than 3 months have passed since the transfusion. If this period was from 3 to 6 months, then the recipient is subject to clinical and serological control twice with an interval of 2 months. If more than 6 months have passed since the blood transfusion, a one-time clinical and serological examination is performed.

Methods preventive treatment syphilis

Prevention carried out according to indications for pregnant women who are sick or have had syphilis, and children born to such women.

Preventive treatment of syphilis is indicated for women who received treatment before pregnancy, who did not have complete negativity of the CSR by the beginning of pregnancy, as well as for all women who began treatment during pregnancy, regardless of its duration. Preventive treatment is usually carried out starting from the 20th week of pregnancy, but if specific treatment is started late, immediately after it.

When a child is born without manifestations of syphilis from an untreated mother, when specific treatment of the mother is started late (from the 32nd week of pregnancy), in the absence of negativity of CSR (MR) at the time of birth or seroresistance in the mother, preventive treatment of syphilis is given to the child.

Preventive treatment of a child born to an untreated mother with syphilis is carried out using any of the methods intended for the treatment of congenital syphilis.

Method of trial treatment of syphilis

Trial treatment may be prescribed if specific damage to internal organs is suspected, nervous system, sensory organs, musculoskeletal system and the like, when the diagnosis cannot be confirmed by convincing laboratory data, and clinical picture does not allow us to exclude the presence syphilitic infection.

In cases complete absence the possibility of using methods of laboratory diagnosis of syphilis, it is permissible to use the so-called epidemiological (syndromic) treatment based on clinical and anamnestic data.

For patients with gonorrhea with unknown sources of infection, serological testing for syphilis is recommended.

Study cerebrospinal fluid With diagnostic purpose performed on patients with clinical symptoms damage to the nervous system. It is also advisable for latent, late forms of syphilis and for secondary syphilis with manifestations in the form of alopecia and leukoderma. Liquorological examination is also recommended for children born to mothers who have not received treatment for syphilis.

A consultation with a neurologist is carried out if the patient has relevant complaints and neurological symptoms are identified:

paresthesia,

numbness of the limbs,

weakness in legs

back pain,

>headaches

dizziness,

seizure in a patient who has not previously suffered from epilepsy,

diplopia,

progressive decrease in vision and hearing,

facial asymmetry, etc.).

When treating a patient with syphilis and carrying out preventive treatment, it is necessary to study the CSR (MRP) before and after the end of treatment.

Treatment methods for complicated syphilis with concomitant diseases

Let's try to find out how syphilis is treated with concomitant diseases. Patients with syphilis should be tested for HIV and, if indicated, for other sexually transmitted infections. If a patient with syphilis is diagnosed with gonorrhea, chlamydia or other urogenital infections, their treatment is carried out in parallel with the treatment of syphilis.

If HIV antibodies are detected in a patient, he is sent for further examination, treatment and constant monitoring V regional center on the prevention and control of AIDS with corresponding recommendations for the treatment of syphilis. The indication for the use of the method of treating syphilis with benzylpenicillin and other groups of antibiotics is the establishment of a diagnosis of syphilis at any stage, with differences in dosages and duration of treatment. Benzylpenicillin drugs are the main ones in the treatment of all forms of syphilis. Semi-synthetic penicillins - Oxacillin or Ampicillin - can be used.

Drug treatment of syphilis with drugs with concomitant diseases

Before treating syphilis with concomitant diseases, it is necessary to clarify the issue of tolerability of penicillin drugs in the past and record this in the medical documentation. In cases where there are anamnestic indications of individual intolerance to Penicillin, an alternative (backup) treatment method should be selected for the patient.

When treating with Doxycycline and Tetracycline in the summer, patients should avoid prolonged exposure to direct sun rays in view of possible manifestation photosensitizing side effect. It is not recommended to prescribe drugs of the tetracycline group when treating children under 8 years of age, as these drugs interact with bone tissue.

Treatment of complicated forms of syphilis in pregnant women

For pregnant women, due to contraindications to the use of tetracycline drugs, it is recommended to prescribe erythromycin in the same daily and single doses and with the same course duration as for treatment with Tetracycline. Since erythromycin does not cross the placenta, the baby must be treated with Penicillin after birth.

Specific treatment for pregnant women up to 18 weeks inclusive is carried out in the same way as the treatment of non-pregnant women, according to one of the methods proposed in these recommendations, in accordance with the diagnosis.

Outpatient treatment of syphilis with concomitant diseases and medications

IN outpatient setting in the treatment of syphilis with concomitant diseases, foreign durable drugs of penicillin are used - Extensillin and Retarpen, as well as their domestic analogue– Bicillin-1. These are single-component drugs representing the dibenzylethylenediamine salt of Penicillin. Their single administration in a dose of 2.4 million units ensures the preservation of the treponemocidal concentration of Penicillin in the patient’s blood serum for 2–3 weeks; injections of Extensillin and Retarpen are carried out once a week, Bicillin - 1–1 times every 5 days.

IN outpatient treatment Bicillin-3 and Bicillin-5 can also be used. Three-component domestic Bicillin-3 consists of dibenzylethylenediamine, novocaine and sodium salts of penicillin in a ratio of 1: 1: 1. Injections of this drug in a dose of 1.8 million units are given 2 times a week. Two-component bicillin-5 consists of dibenzylethylenediamine and novocaine salts of penicillin in a ratio of 4: 1. Injections of this drug in a dose of 1,500,000 units are made once every 4 days.

Medium-duration drugs - domestic novocaine salt of Penicillin and foreign Procaine-penicillin - after their administration in a dose of 0.6-1.2 million units ensure that Penicillin stays in the body for 12-24 hours. These drugs are used intramuscularly 1-2 times per day. Durant and medium-duration drugs are administered intramuscularly, into the upper outer quadrant of the buttock, in two stages.

IN inpatient conditions They use the sodium salt of penicillin, which provides a high initial concentration of the antibiotic in the body, but is eliminated quite quickly. Optimal in terms of ease of use and high efficiency is the administration of penicillin sodium salt at a dose of 1 million units 4 times a day.

The calculation of penicillin preparations for the treatment of children (specific, prophylactic and preventive) is carried out in accordance with the child’s body weight: at the age of up to 6 months, the sodium salt of penicillin is used at the rate of 100 thousand units/kg, after 6 months - 50 thousand units/kg. Daily dose of novocaine salt (Procaine-penicillin) and single dose Durant drugs are used based on body weight.

Antibiotic therapy for syphilis

Let's talk about what methods of treating syphilis with antibiotics exist.

Treatment with Doxycycline

One of the preferred reserve drugs is Doxycycline, which is used 0.1 mg 2 times a day. The duration of preventive treatment is 10 days, treatment of primary syphilis is 15 days, secondary and latent early syphilis is 30 days.

Penicillin treatment method

Semi-synthetic Penicillins - Oxacillin or Ampicillin - can be used. These drugs are administered intramuscularly at 1 million units per injection (dose diluted in 5–6 ml of distilled water) 4 times a day. The duration of preventive treatment is 10 days, treatment of patients with primary syphilis is 14 days, secondary and latent early syphilis is 28 days. Children with penicillin intolerance are often able to be treated with semi-synthetic Penicillins, maintaining the same duration of treatment as when using soluble penicillin for prophylactic purposes.

Treatment with Ceftriaxone

Ceftriaxone is prescribed for preventive treatment at 0.25 g daily for 5 days, for primary syphilis 0.25 g daily for 10 days, for secondary and early latent syphilis 0.5 g daily for 10 days. For patients with late latent and neurosyphilis, a daily dose of 1.0–2.0 g, administered in one injection, is recommended for 14 days. In severe cases (syphilitic meningoencephalitis, acute generalized meningitis) it is possible intravenous use drug and increasing the daily dose to 4.0. The method of preventive treatment with Ceftriaxone in children has not been fully developed. From the literature it is known that treatment is carried out for 10 days, daily dose 50 mg/kg body weight administered in one injection.

Azithromycin therapy

Treatment methods for syphilis with Tetracycline

Tetracycline is used in a daily dose of 2.0 g (0.5 g 4 times a day). Attention should be paid to maintaining equal intervals between doses of the drug (6 hours). The duration of treatment is the same as when using Doxycycline.

The fight against syphilis is based on a course of antibiotics, to which the causative agent of syphilis is very sensitive (long-acting penicillins). It is very important that all sexual partners of the patient who have had intimate contact with him undergo treatment within three months if we are talking about primary syphilis, and within a year if secondary syphilis is detected.

In conclusion about the features of treatment of the disease

Treatment of syphilis is carried out anonymously. After completion, the patient must long time be observed by a dermatovenerologist.

For therapy to be effective, it is necessary accurate diagnosis, confirmed laboratory tests. The patient’s recovery must also be confirmed by laboratory tests; the disappearance of symptoms is not enough for this.

The course of treatment for the disease can be completed on an outpatient or inpatient basis, but in any case, the patient must completely abstain from sexual activity until full recovery.

Antibacterial therapy. The patient must undergo a course of antibiotic injections penicillin series. The sooner the course begins, the sooner recovery will occur.

But in any case, treating the disease is a long process. With primary syphilis it lasts several weeks, with secondary syphilis it lasts more than two years.

The treatment regimen is developed according to individual indications and requires constant monitoring by a specialist.

The problem of seroresistance in the treatment of syphilis

Maintaining persistent positivity of the CSR (MRP) after full treatment regarding the early stages of syphilis - this is seroresistance in syphilis. Seroresistance in syphilis is established in cases where, within a year after the end of therapy, the results of RSK with treponemal and cardiolipin antigens or the results of MR remain persistently positive without a tendency to reduce the reagin titer. In these cases, additional treatment is prescribed.

If, a year after full treatment, negativity of CSC (MRP) has not occurred, but there is a decrease in the titer of reagins (at least 4 times) or a decrease in the degree of positivity of CSC from strongly positive to weakly positive, then these cases are considered as delayed negativity of seroreactions, and observation continue for another 6 months. If during this time the decrease in RSC positivity continues, then observation can be continued for another 6 months. If there is no further decrease in RSC positivity, additional treatment is carried out. Thus, additional treatment is carried out taking into account the dynamics of ESR in a period of 1 to 2 years after the first treatment, usually once.

Methods of additional treatment of seroresistance in syphilis

Additional treatment should be carried out using methods that ensure sufficient high level antibiotic concentration in the body. Therefore, it is preferable to use soluble penicillin or drugs of medium duration.

Method No. 1.

Treatment is carried out in a hospital with soluble Penicillin at a dose of 1 million units 6 times a day for 20 days.

Method No. 2.

Treatment is carried out on an outpatient basis with Procaine-penicillin 1.2 million units once a day for 20 days or novocaine salt of penicillin 600,000 units 2 times a day for 20 days.

Method No. 3.

In exceptional cases, treatment can be carried out with durable Penicillin drugs according to the methods recommended for secondary and early latent syphilis.

Method No. 4.

Treatment is carried out with Ceftriaxone 1.0 g intramuscularly every other day. Total quantity – 10 injections.

Therapy for seroresistance in children is carried out similarly, taking into account the age and body weight of the child when calculating the dose.

“Will a condom help protect against Treponema pallidum infection?” - the question is quite relevant.

The causative agent of syphilis is Treponema pallidum, which can enter the human body through the skin or mucous membranes. Greatest risk infection occurs through unprotected sexual intercourse. “Does a condom protect against syphilis?” – the question is very relevant, so it should be considered in more detail.

Before you find out whether you can get infected with syphilis through a condom, you should clarify how you can catch the infection.

The causes of infection can be:

• sexual contact with a sick person;
• kiss;
• infusion of infected blood;
• entry of spirochetes into the body through wounds on the body;
• using other people's things;
• carrying out medical manipulations non-sterile instruments.

The source of spread of the causative agent of syphilis is any biological fluid. These include:

Source of infection and photo	Short description
Blood	Most infectious diseases are transmitted through blood. When treponemas begin to actively reproduce, they spread through the bloodstream, which increases the risk of transmitting the disease in this way.
Vaginal discharge	Mucous secretions are a source of spread of bacteria from a woman to her sexual partner.
Sperm	IN male sperm contained greatest number Treponem.
Mucus from the intestines	Contributes to the transmission of the disease during anal sexual intercourse.
Saliva	Infection can occur through a kiss or when using non-disinfected dental instruments, someone else's toothbrush, dishes, etc.
Discharge from syphilitic rashes	The discharge from pustules at the second stage of the disease is especially dangerous. Even a simple handshake if there is damage to the skin can cause infection.
Tears	Data on the infectiousness of this type of biological fluid remain unconfirmed.

Protection efficiency

The barrier method of contraception allows you to avoid with a probability of 95 - 98% unwanted pregnancy. Protection against STIs is provided in approximately 70 - 85% of cases.

A decrease in the percentage of protection is associated with improper use, slippage of the condom, and the likelihood of exchange biological fluids on unprotected areas (pubis, scrotum, thighs, etc.).

When exchanging bodily fluids, for example, during a kiss, there is a risk of infection, including sexually transmitted diseases.

Is syphilis transmitted through a condom if the material has a porous structure?

High-quality latex products are very durable and have pores with a diameter of up to 0.02 microns. Cheaper materials have values ​​of 0.1 microns. Despite the significant difference in numbers, any condom, if used correctly, can prevent the sexual transmission of Treponema pallidum.

Penetration of spirochetes through a condom is excluded due to the fact that the pore diameter is much larger. smaller sizes pathogenic microorganisms. Their thickness is as much as 0.25 - 0.35 microns, which is 2.5 - 3.5 times larger than the holes in the structure of the lowest quality condom.

Benefits of using condoms

In order to significantly reduce the likelihood of infection with syphilis or other sexually transmitted diseases, it is not necessary to completely exclude sexual relations with other people from your life. The condom has always been and remains an excellent universal protection option.

The advantages of using condoms are:

1. Vastness protective functions . This good protection from HIV, syphilis and other sexually transmitted diseases, as well as unplanned pregnancy.
2. Structure of the material. Possesses high performance strength, the pores are small enough to block the passage of pathogenic microorganisms and sperm.
3. Availability. You can buy condoms at any pharmacy, store, or kiosk. Available different variants price category and performance.
4. Maintaining a natural feeling. The material is very thin, so it practically does not affect the sensations during sex.
5. Ease of use. For those who have not used condoms before, the product comes with instructions on how to use it correctly.

Disadvantages of the method

Whether a condom protects against syphilis depends on several factors. In this regard, it is impossible to give a 100% guarantee of protection against STIs. This is the main drawback of the method.

It is associated with the following risks:

• misuse;
• violation of the integrity of the material;
• violation of product production technology;
• improper storage, which affects quality indicators in the future;
• slipping during or after sexual intercourse.

Usage errors

It is the correct use of a contraceptive that has the greatest influence on whether it is possible to become infected with syphilis with a condom. Even those who have repeatedly used condoms can make common mistakes.

The most common ones include:

• damage to the membrane by nails, teeth or sharp objects at the moment of opening the package;
• incorrect putting on of the product;
• foreplay and sexual intercourse without protection;
• incorrect selection of lubricant;
• removing the condom before completing sexual intercourse.

It is important to put the condom on correctly before sexual intercourse so that it does not slip off. In this case, contact should not be allowed outside products with secretions from the penis and saliva of a man.

Also important aspect is timely withdrawal of the penis after ejaculation. If you delay, the penis will decrease in size and the condom will simply slip off.

If the product used turns out to be defective, damaged or breaks directly during sexual intercourse, its effectiveness in terms of protection against STIs will decrease to almost zero.

Female condoms and their effectiveness

In addition to traditional condoms, there are also barrier contraceptives for women.

They are not particularly popular for a number of reasons:

• higher price;
• unpleasant odor of the product;
• difficulty putting on;
• increased risk of slipping during sexual intercourse;
• risk of slippage with weak vaginal muscles;
• relative inconvenience compared to male version products.

At correct use The female condom perfectly protects against both STIs and unwanted pregnancy. It has the appearance of a larger male condom, but with rings on both sides.

The inner ring is inserted into the vagina and fixed, covering the cervix. The outer ring is attached to the outside, covering the mucous membranes.

Other preventive measures

Due to the wide range of transmission options for the causative agent of syphilis, it is important not only to use a condom correctly during sexual intercourse, but also to generally take care to reduce the risk of infection.

Prevention of transmission dangerous disease are the following measures:

1. Quantity limit random connections. For your own safety, it is better to give up promiscuous sex life and get a trusted, permanent partner.
2. Prohibition on using other people's things. Personal hygiene items must be strictly individual. The same applies to other things that can serve as a tool for transmitting Treponema pallidum (clothing adjacent to the body, dishes, decorative cosmetics).
3. Use of medical and cosmetology services from trusted clinics. Typically, institutions with a high rating value their reputation, and therefore carefully monitor compliance with sanitary and hygienic standards by their employees. This applies to the use of sterile instruments, masks and gloves, disposable furniture covers, etc.
4. Regular medical examination. Modern techniques studies make it possible to detect syphilis at any stage, even in incubation period. The sooner this is done, the easier the treatment will be.
5. Timely completion of treatment. If a disease is detected in you or your partner, the doctor will prescribe the appropriate drug treatment until the problem leads to irreversible consequences.

You can get more information on the topic that interests you by watching the video in this article.

Syphilis is one of the most common venereal diseases. The disease has a specific course and symptoms, is considered very contagious, therefore, it has long been developedmeasures to prevent syphilis, this is especially important for children and pregnant women.

Activities include a set of actions in the individual and public spheres aimed at preventing Arazheni e. Existing recommendations can be divided into types: individual prevention and public, then nonspecific and specific, and also there are primary and secondary preventive actions. All types complement each other, and only A complex approach solves the initially posed problem.

Public prevention measures

Specified prevention of syphiliscarried out by employees medical institutions, consists of the following actions:

• regular examinations of the population to detect the disease;
• timely examination of pregnant women;
• sanitary and educational work among teenagers;
• treatment and medical examination of those who are sick and contagious to others.

Individual prevention

Such measures are based on warning syphilis infection, successful result depends on everyone individual person. There are a number of recommendations for the implementation of which a person is responsible to himself and society. Often, it is failure to follow recommendations that leads to infection.

The following measures will help prevent infection:

• safe sex. It's about, both about condoms for any type of sex, and about choosing a reliable partner;
• maintaining personal hygiene in terms of using your own household items - razor, towel, washcloth. Health care workers who come into contact with various biological fluids use PPE - gloves, masks, etc.;
• disinfection. If unprotected sexual intercourse has taken place, it makes sense to treat the genitals with an antiseptic - a solution of chlorhexidine or another remedy. Sometimes like this emergency prevention of syphilisprotects against infection;
• before the beginning sexual relations with a new partner, both should get tested;
• regular preventive examinations and taking tests will allow problems to be resolved in a timely manner.
  

Preventative treatment

For such an insidious disease assyphilis prevention using the above measures is not the only thing that can protect a person. In particular, for persons who have been in contact with a sick person (including children, pregnant women), as well as newborns whose mother was sick, medication is providedpreventive treatment.

The same applies to persons who received blood transfusions from patients with syphilis. For this purpose, antibiotics are prescribed, more often from the penicillin group. Patients who are intolerant to this substance are prescribed antibacterial drugs from other groups.

Treatment of syphilisin adults, for the purpose of prevention, it involves prescribing an antibiotic in different forms:

• Water-soluble penicillin is administered daily, the dose is divided into 8 doses every 3 hours, even at night. The course lasts 14 days;
• injections twice a day sodium salt penicillin. Course – 14 days;
• An injection of the durant form of penicillin is given twice a week. This is Bicillin-1 or Bicillin-3. The course lasts 14 days.

If the patient is intolerant to penicillin, he is prescribed drugs from the group of tetracyclines (Doxycycline), macrolides (Azithromycin, Erythromycin). The doctor prescribes a specific drug based on data about the patient’s health, age and course of the disease.

This treatment is prescribed if no more than 3 months have passed since the date of contact. If the period is 3-6 months, before taking the medication, the patient is prescribed 2 examinations with a break of 2 months. If from the moment potentially dangerous contact More than 6 months have already passed, one examination is enough. If received negative result, there is no need to undergo treatment.

Preventive treatment in children is carried out for the same reasons - if there has been sexual / household contact with sick people. Potentially infected children under 3 years of age are prescribed antibiotics. For children over 3 years of age, the doctor decides on the need for preventive treatment on an individual basis. Children, like adults, are prescribed drugs from the penicillin group. For those who have not yet reached 2 years of age, sodium / novocaine salt of penicillin is administered. Those who are older are allowed to administer bicillins. An alternative is synthetic penicillins - Ampicillin and Oxacillin. The convenience of Ampicillin is that it can be taken in tablets.

Measures to prevent congenital syphilis

Considering that Treponema pallidum, which causes syphilis, penetrates the placental barrier, the fetus may well become infected from a sick mother. If a pregnant woman has been in contact with an infected person/suffered from syphilis, after birth the baby should be examined by specialists: a dermatovenerologist, pediatrician, otolaryngologist, ophthalmologist and neurologist. X-rays of the extremities and blood tests are required. If necessary, they can take fluid from the spinal cord for analysis.

Cephalosporins and penicillins are prescribed as needed in a course of 2-3 weeks, the dosage is calculated individually, taking into account the body weight of the infant.

In some situationsprevention of congenital syphilisnot needed, these are the following cases:

• the woman suffered from the disease and underwent treatment before pregnancy;
• during pregnancy, the woman took an antibiotic for prophylactic purposes;
• the newborn has no signs of illness.

Only if all three of the above conditions are met, drug prophylaxis congenital syphilis is not required.

How to prevent intrauterine infection

If an adult knowshow to avoid getting infected with syphilis, and is able to do everything for this necessary measures, then the fetus in the mother’s belly is absolutely not protected. Intrauterine infection can end in disaster - from fetal death to developmental abnormalities. Therefore, preventive measures have been developed:

• STD testing is done before pregnancy, at the planning stage;
• Several times during pregnancy, a woman is tested for syphilis - during registration, at 26 and 30 weeks, immediately before childbirth. If the result is positive, it is prescribed additional research, and if the disease is confirmed, a course of antibiotic treatment is indicated;
• preventive treatment of pregnant women who have previously been treated for syphilis.

Preventive treatment in pregnant women can prevent infection of the fetus, but not always. If the result does not show effectiveness, the doctor suggests that the woman terminate the pregnancy; the final decision rests with the pregnant woman.

To avoid this choice, when planning a pregnancy, it is worth being screened for sexually transmitted diseases, including syphilis. For those who have recently undergone treatment, it is better not to become pregnant for a while until several tests confirm recovery.

Emergency preventive measures

In case of unprotected sexual intercourse, if there are suspicions that the partner is sick, in the next two days you can resort to emergency measures prevention of STDs. To do this, you need to contact a dermatovenerological dispensary or a venereologist at a clinic so that the doctor prescribes a course antibacterial drugs. It is forbidden to take pills on your own! If the dose is chosen incorrectly or the group of antibiotics is not effective in a particular case, then the symptoms and test results will be blurred, while the disease will rapidly develop.

After the treatment prescribed by the doctor, they take tests, and then again for peace of mind. If no signs of syphilis appear within 2 months, then infection has not occurred.

How to prevent the spread of syphilis

Preventive measures are varied and effective, but much depends on the behavior of those people who carry the infection. To avoid becoming a source of health problems for other people, those infected must take a responsible approach to carrying out the following recommendations and follow certain restrictions:

• at positive result testing for syphilis, it is imperative to undergo the prescribed treatment without delay or interruption - this is dangerous both for your health and for those around you;
• notify all sexual partners with whom you had contact during Lately– they must take tests and check their health, and, if necessary, undergo treatment;
• it is advisable to be treated in a hospital, where the administration schedule will be strictly observed medicines every 3 hours. Modern schemes therapy may offer 1 injection once a week, but such treatment requires careful monitoring;
• At the end of treatment, you need to follow a schedule of visiting a venereologist and taking tests, since syphilis can last a long time, cause relapses, etc. Treatment can last from a couple of weeks to a couple of years, depending on the stage of the disease. During treatment, you need to avoid sexual relations and visit a doctor.

To summarize, it is worth recalling that syphilis is dangerous and very contagious disease, which during pregnancy is dangerous for both mother and child. For all patients, the disease is fraught with complications, as it causes serious aesthetic and physiological disturbances.

Timely preventive diagnostics, sexual choosiness and serious attitude to your health will allow you not to encounter such a disease.

The basis of the treatment method for syphilis is the treatment of organs not surgically using antibiotics containing penicillin, iodine and bismuth. This therapy is as soon as possible allows you to get rid of the causative agent of syphilis - treponema and its effect on the body.

Syphilis is a common disease of our time, infection, which is transmitted sexually, rarely through household contact. The causative agent of the disease is Treponema syphilis, which affects the mucous membranes of all organs. Patients in the early stages of the disease pose the greatest danger.

1. Early (infectious). The form of the disease in which healthy person, without symptoms of syphilis, positive titers are present for two years after infection.
2. Late (non-infectious). A form of the disease in which a healthy person, without symptoms of syphilis, has antibodies from microorganisms in the blood for more than two years after infection.

Acquired syphilis occurs due to the penetration of the pathogen through damaged blood vessels, mucous membranes, cells and blood. The infection period is on average 3 weeks.

According to the manifestation of the disease and the appearance of symptoms, acquired syphilis is:

1. Primary syphilis is characterized by the formation of painless hard ulcers, headache, and muscle pain. In men, the first signs of syphilis itself are blood during urination. Treatment at this stage will take from 3 to 10 weeks.
2. Secondary is characterized by fever, malaise, rash, and the appearance of brown and red spots.
3. Tertiary is characterized by damage of cardio-vascular system or central nervous system. The age of such a disease is from 6 to 10 years from the moment of infection. This stage is considered virtually non-contagious.

Congenital syphilis is transmitted from a sick mother through the placenta to the child.

Treatment

Syphilis can be treated at all stages, preferably timely treatment– the results will be more effective and the forecasts will be more favorable. Appropriate treatment is established after the diagnosis is determined.

The diagnosis is made on the basis of laboratory tests, detection of the causative agent Treponema syphilis and the results of blood serum examinations (RSC, MRP (RPR, VDRL) RIBT, ELISA (enzyme-linked immunosorbent assay), RIF, RPGA). ELISA is the most common method for determining sexually transmitted infections (when the body produces antibodies).

Specific treatment is prescribed for people with confirmed syphilis. According to statistics, 30% of people who have sexual intercourse with a patient with primary syphilis can become infected. They are prescribed - Preventive treatment.

Therapy and prevention of infection development

Preventative treatment is given to people with congenital syphilis, former patients with syphilis, pregnant women or their children. The most modern method of treating syphilis is the use of antibiotics containing penicillin. The peculiarity of the mechanism of penicillin is associated with a decrease in the growth of microorganisms and causes their death. The causative agent of the disease dies when exposed to these agents ( bactericidal effect).

The main advantages of this treatment are:

• Prevention of the spread of infection, that is, if the patient is treated with penicillin, he will not infect others;
• Rapid reduction of negative clinical indicators;
• After treatment, reappearance of the disease is extremely rare;
• Efficient and quick results improvement of tests, which indicates successful treatment.

Therapy for syphilis includes therapeutic and preventive measures to improve the patient’s body from treponema and prevents the development of seroresistance (these are persistent positive non-treponema tests for syphilis - microreactions, after precise and complete treatment).

A group of drugs based on penicillin

The main drugs that represent this group are benzylpencillin, ceftriaxone, ampicillin. The advantages of these drugs are rapid absorption into the blood and removal from the body.

Durant benzylpenicillin drugs are the most effective among penicillin drugs. Such drugs that have a longer therapeutic effect than other antibiotics containing the same drugs.

According to laboratory studies, durant drugs are not effective in the treatment of latent primary syphilis and the first six months of secondary syphilis. Positive microreactions to treponema.

That is, the antibodies of the disease remain insensitive and resistant to long-acting penicillins. Such drugs form a low concentration of the substance in the blood serum and are insufficient for antibactericidal action.

Then the patient is given an improved formula of the drug - benzylpenicillin, fast acting medicine, or Procaine-penicillin – a drug of “medium” duration. Both substances are safe for use at home. The treatment mechanism is simple, it is necessary to maintain a certain contraction of the substance, for this an injection is given intramuscularly every 3 hours.

Treatment regimen for adults: bicillin - 1,200,000 units is administered intramuscularly over six days. The most the best medicine in the treatment of syphilis, despite the disadvantages of administration, is benzylpenicillin. Therapy takes place in the hospital, with an average of 4-6 injections per day.

This drug is relevant in the treatment of the disease after six months of infection or in later periods diseases like medicine average speed actions. The concentration is achieved sufficient to kill typical treponemas and other modified forms of microorganisms.

Other types of antibiotics

However, it is not always possible to treat with penicillin. Some patients experience allergic reactions to penicillin in the form of urticaria or anaphylactic shock. Therefore, it is necessary to correctly select treatment for each patient according to all laboratory research. An alternative to treatment with penicillins is the use of cephalosporin antibiotics.

The causative agent of syphilis is hypersensitive to the drug of this group. Cephalosporins act like penicillin drugs and are suitable for the treatment of diseases on late stage. The course of treatment takes 20 days. Therapy with cephalosporins can achieve positive results.

“Love diseases” are also treated with other types of antibiotics: erythromycin, tetracycline, doxycycline. The effectiveness is significantly less than that of penicillin and cephalosporin. Analogue drugs limit the reproduction and growth of treponema, but do not completely destroy the infection. These medications are used if allergic reactions to the main drug have been observed. They are used for preparatory therapy before the main treatment of late syphilis.

In case of intolerance, ceftriaxone tablets are used for 14-28 days or intramuscularly.

Prevention of syphilis

To prevent syphilis, preparations based on bismuth salt are recommended. Bismuth therapy has become a new step in the treatment of syphilis - powerful effective results the means have become darkened individual intolerance, side complications. Bismuth nanoparticles are less toxic and have a good effect at the molecular and cellular level.

For prevention, it is recommended first of all to the right image life, nutrition. Choose your partner thoughtfully and selectively and use protective equipment. If there is any suspicion, carry out sanitization with Meratin.

After sexual intercourse, go to the toilet, wash your hands and genitals with soap. Prepare the required area for treatment. Then wipe intimate area with a cotton swab moistened with a solution of sublimate 1:1000. Using a pipette, drop 2-3 drops into the urethra percentage solution protargola; 0.05 percent solution of hibitan, do not go to the toilet for 2-3 hours for effectiveness.

You should not self-medicate traditional methods and ways. Be healthy!