Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis

Katanami, Yuichi; Hashimoto, Takehiro; Takaya, Saho; Yamamoto, Kei; Kutsuna, Satoshi; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Ohmagari, Norio

doi:10.3201/eid2305.161936

Cited by 27 publications

(29 citation statements)

References 9 publications

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“…While syphilis rates are at their highest in 20 years, penicillin benzathine G has become unavailable in many hospitals [41]. In Japan, amoxicillin has been successfully used as an alternative to penicillin benzathine G to treat syphilis infection and prevent mother-to-child transmission [42, 43]. …”

Section: Sti Managementmentioning

confidence: 99%

The growing epidemic of sexually transmitted infections in adolescents: a neglected population

Shannon

Klausner²

2018

Current Opinion in Pediatrics

211

123

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STIs are a growing concern for adolescents. Routine screening and management are of critical importance. Furthermore, prevention efforts such as human papillomavirus vaccination should be prioritized. Much of the current literature on STIs does not address the unique nature of STIs in adolescents, and additional research into effective prevention and treatment strategies of STIs in adolescents is urgently needed.

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Section: Sti Managementmentioning

confidence: 99%

The growing epidemic of sexually transmitted infections in adolescents: a neglected population

Shannon

Klausner²

2018

Current Opinion in Pediatrics

211

123

View full text Add to dashboard Cite

show abstract

“…In the study of Moline et al [30], penicillin was considered as the only known effective treatment during pregnancy. However, some studies have put focus on alternative treatment on syphilis, including ceftriaxone, amoxicillin, and doxycycline [31][32][33][34]. In our study, penicillin is the first choice for anti-syphilis, except those allergic patients.…”

Section: Discussionmentioning

confidence: 86%

Effect of RPR titer of pregnant syphilis on adverse outcome and treatment in 2013-2018, Nanjing, China: a retrospective study

Wang

Han

et al. 2020

Preprint

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Background: We aimed to find the relationship among syphilis Rapid Plasma Reagin (RPR) titer of syphilis infected pregnant women, RPR positive rate of the newborn, the adverse pregnancy outcomes and therapies.Method: A total of 600 syphilis infected pregnant women and their infants were participated in our study. Syphilis RPR Test and Treponema pallidum particle agglutination (TPPA) test screening were performed on mothers and these infants. Mothers were divided into six groups depending on different treatments.Results: The higher the RPR titer of the pregnant mother was, the higher the RPR titer of their newborns after birth. The number of newborns in double negatives (RPR negative and TPPA negative), TPPA positive (RPR negative), RPR < 8 and RPR ≥ 8 groups (P < 0.01) has significantly difference. The infants with TPPA positive and RPR < 1:8 have more possibility to turn double negative than those RPR ≥ 8 infants after 12 months. Among all the adverse events, the number of premature births was significantly higher than others (P < 0.01). The proportion of adverse events achieved highest in RPR ≥ 1:8 group (11.24%), compared with the TPPA positive group (8.41%) and RPR < 1:8 group (2.56%). Therapy efficacy of mothers was better in RPR ≥ 1:8 group than RPR < 8 and TPPA positive groups (P < 0.01).Conclusions: RPR titers of 1:8 could be used as a point of therapeutic induction, which need to be emphasized.

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“…The therapeutic regimen for the neonate depends on the clinical, laboratory and radiographic findings, and it ranges from a single administration of penicillin to daily doses of the medication for ten days 20,22 . In Rio Branco, the therapeutic regimen adopted for newborns exposed to syphilis was predominantly ceftriaxone.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, in the year 2016 the Ministry of Health produced a memorandum recommending the use of ceftriaxone for the treatment of congenital syphilis 24 . However, the literature states that there are no studies proving the efficacy of antibiotics other than penicillin for the treatment of congenital syphilis and pregnant women with syphilis 25,22 . It can be deduced that the long-term repercussions of the treatment of congenital syphilis with ceftriaxone in the population studied are still unknown.…”

Section: Discussionmentioning

confidence: 99%

Prenatal quality and clinical conditions of newborns exposed to syphilis

Pastro

Farias

Garcia

et al. 2019

jhgd

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Introduction: Syphilis is a sexually transmitted disease caused by Treponema pallidum, and results in considerable morbidity and mortality. Congenital syphilis can lead to miscarriage, prematurity, bone deformities, hearing loss and other important clinical changes. Objective: To analyze prenatal quality and clinical conditions of newborns exposed to syphilis in a public maternity hospital in Rio Branco-Acre. Method: This is a cross-sectional study that included 92 mothers diagnosed with syphilis during pregnancy, attended from July to December 2017. Two pregnant women had fetal death, and the final sample consisted of 90 newborns exposed to syphilis. An interview with the postpartum woman was used, analysis of the pregnant woman's card and search for information from the pregnant woman's records and newborns. It was considered confirmed case of syphilis in pregnant woman: a) All pregnant women who presented non-treponemal reagent test with any titration and reagent treponemal test performed during prenatal care; b) Pregnant woman with reagent treponemal test and nonreactive or unreacted nontreponemal test, without previous treatment record. To characterize congenital syphilis we considered: a) newborn whose mother was not diagnosed with syphilis during pregnancy and who presented a nontreponemal test reactive with any titration at the time of delivery; b) child whose mother was not diagnosed with syphilis during pregnancy and had a non-treponemal test reagent at the time of delivery; c) newborns whose mother presented a reactive treponemal test and a nonreactive non-treponemal test at the moment of delivery, without previous treatment record. Results: Most newborns were born in normal delivery (65.5%), 17.8% had acute fetal distress and 11.2% required resuscitation maneuvers. Prematurity occurred in 10% of births and 12.2% of them were small for gestational age. Complete prenatal care was performed by 29.5% of the mothers, following the recommendations of the Ministry of Health of seven visits to the Health Unit and or Health Professional. From the 90 pregnant women, 79 had a reactive treponemal test when admitted to the maternity ward. 29.3% of them performed the treatment properly. In the analysis about the treatment of the sexual partner, it was reported that 58% did not adhere to syphilis treatment. Conclusion: The prenatal quality of pregnant women with syphilis was lower than that recommended by the Brazilian Ministry of Health, although there are few cases of syphilis as the primary outcome in newborns with childbirth with mothers diagnosed with syphilis. Prenatal, newborn, syphilis in pregnancy, congenital syphilis.

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Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis

Cited by 27 publications

References 9 publications

The growing epidemic of sexually transmitted infections in adolescents: a neglected population

The growing epidemic of sexually transmitted infections in adolescents: a neglected population

Effect of RPR titer of pregnant syphilis on adverse outcome and treatment in 2013-2018, Nanjing, China: a retrospective study

Prenatal quality and clinical conditions of newborns exposed to syphilis

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