title: Pyrimethamine-sulfadoxine treatment of congenital toxoplasmosis: follow-up of 78 cases between 1980 and 1997. Reims Toxoplasmosis Group.
abstract: The purpose of this study was to determine the clinical and immunological outcome of 78 children with congenital toxoplasmosis treated with the pyrimethamine-sulfadoxine combination between 1980 and 1997.
  
  
  METHODS
  Children were divided into 3 groups according to the initial duration of treatment (always including folinic acid, 5 mg/week by mouth), as follows: pyrimethamine (1.25 mg/kg every 15 d) + sulfadoxine (25 mg/kg every 15 d) for 12 months (Group 1, 47 children), or for 24 months, with or without prenatal therapy (respectively, Group 2, 19 children, and Group 3, 12 children).
  
  
  RESULTS
  Chorioretinitis occurred in 23% of these 78 children. Four children had unilateral blindness, 1 had mild epileptic fits and 1 had psychomotor retardation. The lowest rate of sequelae were in Groups 2 and 3. Immunological rebounds, generally without clinical repercussions, occurred frequently (90% of cases on average) during, or more often after therapy, regardless of the treatment duration. Treatment was always well tolerated.
  
  
  CONCLUSIONS
  Our current treatment strategy for congenital toxoplasmosis consists of a 24-month course of pyrimethamine-sulfadoxine (Fansidar) combined with folinic acid (Lederfoline). If the prenatal diagnosis is positive, we also prescribe this treatment to the mother until delivery. This combination offers satisfactory compliance, adequate serum concentrations, and good preventive efficacy.
authors.affiliation: Service de Parasitologie (Team 4 INSERM U.314, EA 2070, IFR 53), CHU, Hôpitaux Maison Blanche, Reims, France.
authors.forename: I
authors.initials: I
authors.lastname: Villena
authors.forename: D
authors.initials: D
authors.lastname: Aubert
authors.forename: B
authors.initials: B
authors.lastname: Leroux
authors.forename: D
authors.initials: D
authors.lastname: Dupouy
authors.forename: M
authors.initials: M
authors.lastname: Talmud
authors.forename: C
authors.initials: C
authors.lastname: Chemla
authors.forename: T
authors.initials: T
authors.lastname: Trenque
authors.forename: G
authors.initials: G
authors.lastname: Schmit
authors.forename: C
authors.initials: C
authors.lastname: Quereux
authors.forename: M
authors.initials: M
authors.lastname: Guenounou
authors.forename: M
authors.initials: M
authors.lastname: Pluot
authors.forename: A
authors.initials: A
authors.lastname: Bonhomme
authors.forename: J M
authors.initials: JM
authors.lastname: Pinon
mesh_terms: D000293:Adolescent; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002825:Chorioretinitis / Q000209:etiology; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D002955:Leucovorin / Q000627:therapeutic use; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use*; D014125:Toxoplasmosis, Congenital / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002955:Leucovorin; D011739:Pyrimethamine