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Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy

Journal of Perinatology volume 35, pages 90–94 (2015)Cite this article

Subjects

Abstract

Objective:

To compare the effectiviness of spiramycin/cotrimoxazole (Sp/C) versus pyrimethamine/sulfonamide (Pyr/Sul) and spiramycin alone (Spy) on mother-to-child transmission of toxoplasmosis infection in pregnancy.

Study design:

Retrospective study of pregnant women evaluated for suspected toxoplasmosis between 1992 and 2011.

Result:

A total of 120 mothers and their 123 newborns were included. Prenatal treatment consisted of spiramycin in 43 mothers (35%), spiramycin/cotrimoxazole in 70 (56.9%) and pyrimethamine/sulfonamide in 10 (8.1%). A trend toward reduction in toxoplasmosis transmission was found when Sp/C was compared with Pyr/Sul and particularly with Spy alone (P=0.014). In particular, Spy increased the risk of congenital infection when compared with Sp/C (odds ratio (OR) 4.368; 95% CI: 1.253 to 15.219), but there was no significant reduction when Sp/C was compared with Pyr/Sul (OR 1.83; 95% CI: 0.184 to 18.274).

Conclusion:

The treatment based on Sp/C has significant efficacy in reducing maternal-fetal transmission of Toxoplasma gondii when compared with Pyr/Sul and particularly to Spy. Randomized controlled trials would be required.

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Acknowledgements

We thank Professor Nicholas P. Brennan for his helpful suggestions in the manuscript’s revision.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy

    P Valentini, D Buonsenso, G Barone, R Calzedda & M Ceccarelli

  2. Department of Pediatrics, Meyer Pediatric Hospital, Florence, Italy

    D Serranti

  3. Department of Microbiology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy

    D Speziale & R Ricci

  4. Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy

    L Masini

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  1. P Valentini
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Correspondence to D Buonsenso.

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Valentini, P., Buonsenso, D., Barone, G. et al. Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy. J Perinatol 35, 90–94 (2015). https://doi.org/10.1038/jp.2014.161

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