Effectiveness and Tolerability of Oral Amoxicillin in Pregnant Women with Active Syphilis, Japan, 2010-2018.

Abstract

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.

• Authors: Takeshi Nishijima, Kei Kawana, Ichio Fukasawa, Naoko Ishikawa, Melanie M Taylor, Hiroshige Mikamo, Kiyoko Kato, Jo Kitawaki, Tomoyuki Fujii, Women’s Health Care Committee, Japan Society of Obstetrics and Gynecology
• Journal: Emerging infectious diseases (Emerg Infect Dis) Vol. 26 Issue 6 Pg. 1192-1200 (06 2020) ISSN: 1080-6059 [Electronic] United States
• PMID: 32441638 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Amoxicillin

Topics

• Amoxicillin (therapeutic use)
• Female
• Humans
• Japan (epidemiology)
• Pregnancy
• Pregnancy Complications, Infectious (drug therapy)
• Pregnancy Outcome
• Pregnant Women
• Prospective Studies
• Retrospective Studies
• Syphilis (drug therapy, epidemiology)