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Volume 26, Number 6—June 2020
Research

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

Takeshi Nishijima, Kei KawanaComments to Author , Ichio Fukasawa, Naoko Ishikawa, Melanie M. Taylor, Hiroshige Mikamo, Kiyoko Kato, Jo Kitawaki, Tomoyuki Fujii, and Women’s Health Care CommitteeJapan Society of Obstetrics and Gynecology
Author affiliations: National Center for Global Health and Medicine, Tokyo, Japan (T. Nishijima); World Health Organization Regional Office of the Western Pacific, Manila, the Philippines (T. Nishijima, N. Ishikawa); Nihon University School of Medicine, Tokyo, Japan (K. Kawana); Dokkyo Medical University, Tochigi, Japan (I. Fukasawa); World Health Organization, Geneva, Switzerland (M.M. Taylor); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.M. Taylor); Aichi Medical University, Aichi, Japan (H. Mikamo); Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan (K. Kato); Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan (J. Kitawaki); Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (T. Fujii)

Main Article

Table 1

Characteristics of pregnant women with active syphilis treated with amoxicillin or ampicillin, by CS birth outcome, Japan, 2010–2018*

Characteristic All cases, n = 80 CS cases,† n = 15 Cases of live birth without CS, n = 56‡ p value§
Age, y 23 (21–27) 24 (22–26) 26 (22–29.5) 0.46
Japanese 75/80 (94) 12/15 (80) 54/56 (96) 0.06
HIV co-infection
 1/78 (1)
 0/15
 1/56 (2)
 1.00
Syphilis stage
Early syphilis 31/80 (39) 0/15 26/56 (46)
Primary 5/80 (6) 0/15 5/56 (9)
Secondary 19/80 (24) 0/15 14/56 (25)
Early latent 7/80 (9) 0/15 7/56 (13)
Late syphilis 49/80 (61) 15/15 (100) 30/56 (54)
Late latent 4/80 (5) 0/15 4/56 (7)
Latent with unknown duration
 45/80 (56)
 15/15 (100)
 26/56 (46)
Diagnosis and treatment
Rapid plasma reagin titer at diagnosis 51 (29–72) 58 (28–105) 51 (27.1–71.8) 0.59
Amoxicillin 66/80 (82.5) 11/15 (73) 47/56 (84) 0.45
Ampicillin 14/80 (17.5) 4/15 (27) 9/56 (16)
Antimicrobial drug dosage, mg/d 1,500 (1,500–1,500) 1,500 (1,500–1,500) 1,500 (1,500–1,500) 0.88
Received 1,500 mg/d 61/80 (76) 13/15 (87) 39/56 (70) 0.20
Co-administered probenecid 3/75 (4) 1/15 (7) 2/56 (4) 0.51
Total duration of treatment, d¶ 60 (29–90) 70 (37–101) 56 (28–90) 0.49
Duration of treatment at delivery, d¶ 56 (28–86) 68 (4–100) 56 (28–84) 0.84
Gestational age at diagnosis, wk¶ 13.8 (11.7–26.3) 18.1 (12.3–34) 13.2 (11.5–21.6) 0.082
Gestational age at treatment, wk¶ 15.8 (13.0–27.1) 18.3 (13.6–34.3) 15.9 (13.4–25.4) 0.22
Gestational age at delivery, wk¶ 39.1 (37.9–40.6) 38.6 (35.6–40.9) 39.1 (37.9–40.3) 0.38
Time from treatment to delivery, wk¶ 21.9 (8.5–26.3) 15.7 (0.4–25.9) 23 (16.7–27.2) 0.026
Started treatment <60 d before delivery¶
 14/69 (20)
 6/14 (43)
 8/56 (14)
 0.027
Birth outcomes
Birth weight, g¶ 2,936 (2,580–3,156) 2,704 (1,797–3,085) 2,959 (2,641–3,180) 0.094
Low birth weight, <2,500 g 11/69 (16) 4/13 (31) 7/56 (13) 0.20
Very low birth weight, <1,500 g 3/69 (4) 3/13 (23) 0/56 0.005

*Values are no./total (%) or median (interquartile range). Pregnancy outcome was missing for 9 patients. CS, congenital syphilis.
†CS cases include newborns with CS diagnoses, miscarriages, and stillbirths.
‡One pregnant woman delivered twins. The twin delivery was acknowledged as 1 birth outcome, and the birth weight of the first child born was used for the table and analyses.
§Student t-test for continuous variables and either χ2 test or Fisher exact test for categorical variables.
¶Denominators varied because of missing data. Anywhere from 1 to 11 cases might be missing.

Main Article

Page created: May 18, 2020
Page updated: May 18, 2020
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