TY - JOUR
T1 - Effectiveness and tolerability of oral amoxicillin in pregnant women with active syphilis, Japan, 2010-2018
AU - Women's Health Care Committee, Japan Society of Obstetrics and Gynecology
AU - Nishijima, Takeshi
AU - Kawana, Kei
AU - Fukasawa, Ichio
AU - Ishikawa, Naoko
AU - Taylor, Melanie M.
AU - Mikamo, Hiroshige
AU - Kato, Kiyoko
AU - Kitawaki, Jo
AU - Fujii, Tomoyuki
N1 - Funding Information:
This work was supported by the Ministry of Health, Labour, and Welfare of Japan.
Publisher Copyright:
© 2020 Centers for Disease Control and Prevention (CDC). All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - We conducted a nationwide retrospective study in Japan to evaluate the effectiveness of oral amoxicillin or ampicillin as alternatives to injectable benzathine penicillin G for treating pregnant women with syphilis and preventing congenital syphilis (CS). We investigated 80 pregnant women with active syphilis treated with amoxicillin or ampicillin during 2010-2018. Overall, 21% (15/71) had pregnancies resulting in CS cases, and 3.8% (3/80) changed therapies because of side effects. Among 26 patients with early syphilis, no CS cases occurred, but among 45 with late syphilis, 15 (33%) CS cases occurred. Among 57 patients who started treatment >60 days before delivery, 8 (14%) had CS pregnancy outcomes. We found oral amoxicillin potentially ineffective for preventing CS cases among pregnant women with late syphilis but potentially effective in those with early syphilis. Prospective studies are needed to definitively evaluate the efficacy of amoxicillin for the treatment of pregnant women with syphilis to prevent CS.
AB - We conducted a nationwide retrospective study in Japan to evaluate the effectiveness of oral amoxicillin or ampicillin as alternatives to injectable benzathine penicillin G for treating pregnant women with syphilis and preventing congenital syphilis (CS). We investigated 80 pregnant women with active syphilis treated with amoxicillin or ampicillin during 2010-2018. Overall, 21% (15/71) had pregnancies resulting in CS cases, and 3.8% (3/80) changed therapies because of side effects. Among 26 patients with early syphilis, no CS cases occurred, but among 45 with late syphilis, 15 (33%) CS cases occurred. Among 57 patients who started treatment >60 days before delivery, 8 (14%) had CS pregnancy outcomes. We found oral amoxicillin potentially ineffective for preventing CS cases among pregnant women with late syphilis but potentially effective in those with early syphilis. Prospective studies are needed to definitively evaluate the efficacy of amoxicillin for the treatment of pregnant women with syphilis to prevent CS.
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U2 - 10.3201/EID2606.191300
DO - 10.3201/EID2606.191300
M3 - Review article
C2 - 32441638
AN - SCOPUS:85085537881
SN - 1080-6040
VL - 26
SP - 1192
EP - 1200
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
IS - 6
ER -
