What is the primary treatment of choice for syphilis?

Penicillin is the primary treatment of choice for syphilis, as it effectively targets the bacterium Treponema pallidum, which causes the infection. This antibiotic is well-studied and has a long history of use for this specific condition, demonstrating both efficacy and safety.

Penicillin works by interfering with bacterial cell wall synthesis, leading to the death of the bacteria. It is particularly effective in all stages of syphilis, including primary, secondary, and latent phases, with different dosages recommended depending on the stage of the disease.

Other antibiotics, such as tetracycline, ciprofloxacin, and doxycycline, may have some efficacy against syphilis, especially in patients who are allergic to penicillin. However, these alternatives are not considered the first line of treatment. Tetracycline and doxycycline are typically used in patients with penicillin allergy or when treatment adherence is more manageable, such as in outpatient settings. Ciprofloxacin is primarily used for other bacterial infections and has no established efficacy in treating syphilis.

Thus, penicillin remains the gold standard due to its proven track record in effectively eradicating the syphilis-causing bacteria and its wide acceptance in clinical practice guidelines.