I. What are the principles of syphilis treatment? Penicillin is the drug of choice for the treatment of syphilis, with definite efficacy and no cases of drug resistance have been found. If you are allergic to penicillin, you can use ceftriaxone sodium, tetracycline or erythromycin. However, tetracyclines are contraindicated in pregnant women and children. Whenever possible, penicillin should be used as an effective and inexpensive treatment. After the diagnosis of syphilis is clear, the earlier the treatment is given, the better the effect, the dosage must be sufficient, the course of treatment must be regular, and the treatment should be followed up. The source of infection and sexual partners or sexual contacts should be examined and treated at the same time. 1.How to correctly determine a positive penicillin skin test? Penicillin allergy should be judged with caution. It is better to use saline as control when penicillin skin test, so that the false positive penicillin skin test allergy caused by positive skin scratch can be excluded, and thus be judged correctly. What is the treatment plan for early syphilis? Treatment of early syphilis (including stage I, stage II syphilis and early latent syphilis): 1. Penicillin therapy: (1) Benzathine penicillin G (long-acting cillin) 2.4 million units, divided into two sides of the buttocks intramuscular injection, once a week, a total of 2 to 3 times. (2) Procaine penicillin G 800,000 units / day, intramuscular injection, for 10 to 15 days, a total of 8 million units to 12 million units. (2) For those who are allergic to penicillin or whose penicillin treatment is ineffective: Ceftriaxone sodium (Rocephin) 1 gram, intravenous drip, once a day for 7~10 days. 3.For those who are allergic to penicillin: (1) Erythromycin 500 mg, 4 times a day for 15~30 days. (2) Doxycycline 100 mg, 2 times/day for 15 days. However, the efficacy of these two oral medications is often unsatisfactory. What is the treatment plan for syphilis in pregnancy? 1, benzathine penicillin G (long-acting cillin) 2.4 million units, divided into two sides of the buttock muscle injection, once a week, a total of 2 to 3 times. One course of injection in the first 3 months of pregnancy, and another course of injection in the last 3 months of pregnancy. 2.For those who are allergic to penicillin, treat with erythromycin, 500 mg each time, 4 times/day, for 15 days for early syphilis and 30 days for second stage relapse and late syphilis. One course of treatment is given in the first 3 months of pregnancy and one in the last 3 months of pregnancy (tetracycline is prohibited). However, the infant born should be treated with penicillin supplementation. IV. What serious adverse reactions can occur during syphilis treatment? It can occur several hours to 24 hours after the first injection of penicillin, which is manifested as an increase in syphilis symptoms and may be accompanied by an increase in body temperature, which can gradually subside after 12 to 24 hours. The mechanism of occurrence may be a temporary reaction caused by the release of endotoxin due to the killing of a large number of spirochetes in the muscle.