Newborn outcomes among pregnant women with oral amoxicillin treatment for syphilis

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  • 妊娠中の梅毒治療にアモキシシリン内服を行った母から出生した児6例

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<p> Congenital syphilis can be prevented by penicillin treatment of pregnant women with syphilis. Benzathine penicillin G is used worldwide, but it is difficult to use in Japan, because of following a fatal case of intramuscular penicillin injection in the 1950s, so, amoxicillin, an oral penicillin drug, is commonly used for the treatment of pregnant women with syphilis. There are few reports on infants born to pregnant women treated with amoxicillin.</p><p> In this study, we examined six pregnant women with syphilis and their newborns who were treated with amoxicillin during antenatal care at our hospital from 2016.1. to 2020.12. Five patients were started on amoxicillin by 15 weeks of gestation, and one patient was first diagnosed at 21 weeks of gestation, so amoxicillin was started at 22 weeks of gestation. All of them received treatment of amoxicillin 1,500mg/day and the median duration of administration was 7.5 weeks（6-12 weeks）, and all cases were completed the administration 1 month before the delivery. In five pregnant women, the rapid plasma regain（RPR）titer, as nontreponemal antibodies, after amoxicillin treatment decreased more than a quarter compared with the pre-treatment RPR, but only one case did not show a quarter decrease. In all cases, the newborn’s RPR titer at birth was reduced to more than a quarter of the mother’s RPR titer at delivery. However, penicillin G treatment was administered to newborn whose RPR titer did not decrease by more than a quarter before and after the mother’s treatment. There were no cases of congenital syphilis diagnosed in all patients. Amoxicillin treatment of pregnant women with syphilis may be expected to prevent congenital syphilis.</p>

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