Abstract: Penicillin has always been the first-line medication for the treatment of syphilis. The substitutes include the third generation cephalosporins, macrolides and tetracyclines. Macrolide-resistant Treponema pallidum (Tp) strains have been prevalent in many regions of the world. In recent years, cases of failure in the treatment of syphilis with tetracyclines have been reported, but the tetracyclines resistance is not widespread. The updata of prevalence of antibiotic resistance of Tp, the reported mutations and the potential molecular mechanism of antibiotic resistance of Tp is reviewed in this paper.

Key words: syphilis, Treponema pallidum, antibiotics, antibiotic resistance