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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 3

Birth outcomes of pregnant women with active syphilis treated with oral amoxicillin or ampicillin, Japan, 2010–2018*

Category Total no. No. missing No. live births without CS diagnosis No. adverse outcomes
 Adverse outcomes, % (95% CI) p value†
Live births with CS diagnosis Miscarriages Stillbirths
All patients 80 9 56 13 1 1 21.1 (13.2–32)
Early syphilis 31 5 26 0 0 0 0 (0–12.9) <0.001
Late syphilis 49 4 30 13 1 1 33.3 (21.4–47.9)
Amoxicillin 66 8 47 9 1 1 19.0 (10.9–30.9) 0.19
Ampicillin 14 1 9 4 0 0 30.8 (12.7–57.6)
Japanese 75 9 54 10 1 1 18.2 (10.7–29.1) 0.033
Non-Japanese
 5
 0
 2
 3
 0
 0
 60.0 (23.1–88.2)
Patients starting syphilis treatment >60 days before delivery‡
All 57 1 48 8 0 0 14.2 (7.4–25.7)
Early syphilis 21 0 21 0 0 0 0 (0–15.5) 0.017
Late syphilis 36 1 27 8 0 0 22.9(12.1–39)
Amoxicillin 46 1 40 5 0 0 11.1 (4.8–23.5) 0.11
Ampicillin 11 0 8 3 0 0 27.3 (9.7–56.6)
Japanese 54 1 47 6 0 0 11.3 (5.3–22.6) 0.026
Non-Japanese
 3
 0
 1
 2
 0
 0
 66.7 (20.8–93.9)
Patients starting syphilis treatment <60 days before delivery
All 14 0 8 5 0 1 42.9 (21.4–67.4)
Early syphilis 5 0 5 0 0 0 0 (0–43.5) 0.028
Late syphilis 9 0 3 5 0 1 66.7 (35.4–87.9)
Amoxicillin 13 0 8 4 0 1 38.5 (17.7–64.5) 0.43
Ampicillin 1 0 0 1 0 0 100 (20.7–100)
Japanese 12 0 7 4 0 1 41.7 (19.3–68.1) 0.86
Non-Japanese 2 0 1 1 0 0 50.0 (9.5–90.6)

*Nine cases (including 3 cases of induced abortion) were excluded from this analysis because data on birth outcomes were not available. One miscarriage case is missing in the subgroup analysis because the exact date of miscarriage was unknown, CS, congenital syphilis.
†Used either the χ2 test or Fisher exact test to measure the association between cases of live birth without CS diagnosis and cases of live birth with CS diagnosis, miscarriage, and stillbirth.
‡Outcome data for 1 patient is missing. Outcome data (whether CS or not) was not known because this patient was referred to another hospital before delivery. Because the birth date of this patient’s infant was reported and available, we could group this patient with the appropriate group, which was the group that started syphilis treatment >60 days before delivery.

Main Article

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