There are several considerable challenges that you are likely to encounter when designing a syphilis treatment plan (as a clinician). The disease in question is caused by one well known organism: the spirochete bacterium. That being the case, one would expect the development of treatment strategies to be a very straightforward affair. But it is going to be easier said than done. The road ahead is going to be tricky, and you're still trying to come up with a treatment plan, too. It does not even have to reach the treatment stage before the complications start coming in. The diagnosis stage alone brings with it comes challenges. That is because the presentations of syphilis is quite roundabout. There is no short cuts with it. The clinician would most likely have a difficult time first before he finally hits the nail on its head and get it right. It is easy to figure out these microbiological tests that are being conducted since they are simple and clear-cut. But you (as a clinician) have to first suspect the disease, in order to be in a position to order those particular microbiological tests. Suspecting syphilis is quite hard because the presentations of the disease do not directly allow one to connect the dots easily. We will now be discussing the other challenges that will be faced once the correct diagnosis has been made, and these challenges are mainly those that take place with respect to the development of the treatment plan's design.
You will have different patients to treat for this condition. Now the first challenge would be trying to find out how their respective conditions have advanced and what stage they are in. Let us say that you have patients in a more advanced stage and other patients that are in the earlier and more simple stages. You cannot expect the same treatment to work for them in the same way. The uncomplicated cases can be treated with a single dose of penicillin through the intramuscular route. The same medication has to be given through the intravenous route, for some 10 days, when dealing with advanced cases. It is important to make the necessary distinctions among the cases so you'd know which case to administer intravenously or intramuscularly, and which case should be given a single dose and which to give multiple doses. It is quite difficult to distinguish the complicated ones from the straightforward ones, though, and that gives a lot of grief to clinicians.
It is also likely that the syphilis has already done quite a number on the patient. The clinician would find it challenging to find some way to ensure that the damage or the effects could be treated or even reversed. Deterioriation could be easily prevented by using medications such as specific antibiotics. But they do not really treat the effects that has already transpired. And yet it is the desire of these patients to fix these problems too.
It is also quite difficult to be able to tell the future; and clinicians are also challenged at every turn to be able to tell how their patients would respond to the treatments. It is possible that the patients have an allergic reaction to certain medication. Penicillin, for one. However, it's hard to predict what their allergies would be. You would also have to be prepared with back up plans or alternate treatments in the event that the first ones did not pull through.