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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 2

Characteristics and birth outcomes of pregnant women with active syphilis treated with amoxicillin or ampicillin, by syphilis stage, Japan, 2010–2018*

Category Early syphilis, n = 31 Late syphilis, n = 49 p value†
Age, y 26 (21–28) 25 (22–27) 0.63
Japanese 29/31 (94) 46/49 (94) 1.00
HIV co-infection
 0/31
 1/49 (2)
 1.00
Diagnosis and treatment
Rapid plasma reagin titer at diagnosis 44 (27–64) 58 (29–83) 0.64
Amoxicillin 28/31 (90) 38/49 (78) 0.23
Ampicillin 3/31 (10) 11/49 (22)
Antimicrobial drug dosage, mg/d 1,500 (1,500–1,500) 1,500 (1,500–1,500) 0.56
Received 1,500 mg/d 26/31 (84) 35/49 (71) 0.22
Total duration of treatment, d‡ 30 (28–64) 78 (51–104) 0.004
Duration of treatment at delivery, d‡ 30 (26–56) 70 (29-98) 0.016
Gestational age at diagnosis, wk‡ 15.1 (11.1–27.5) 13.3 (12–25.6) 0.70
Gestational age at treatment, wk‡ 17.3 (13.3–28.7) 14.7 (13–26) 0.62
Gestational age at delivery, wk‡ 39.4 (38.1–40.6) 38.9 (37.7–40.5) 0.10
Time from treatment to delivery, wk‡
 15.7 (0.4–25.9)
 23 (16.7–27.2)
 0.73
Birth outcomes
Live birth with congenital syphilis diagnosis 0/26 13/45 (29) 0.009
Stillbirth 0/26 1/45 (2)
Miscarriage 0/26 1/45 (2)
Birth weight, g‡ 2,902 (2,652–3,184) 2,942 (2,555–3,155) 0.88
Low birth weight, <2,500 g‡ 3/26 (12) 8/45 (18) 0.52
Very low birth weight, <1,500 g‡ 0/26 3/45 (7) 0.29

*Values are no./total (%) or median (interquartile range).
†Used the Student t-test for continuous variables and either the 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
Page reviewed: May 18, 2020
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