title: Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy.
abstract: OBJECTIVE
  To compare the effectiviness of spiramycin/cotrimoxazole (Sp/C) versus pyrimethamine/sulfonamide (Pyr/Sul) and spiramycin alone (Spy) on mother-to-child transmission of toxoplasmosis infection in pregnancy.
  
  
  METHODS
  Retrospective study of pregnant women evaluated for suspected toxoplasmosis between 1992 and 2011.
  
  
  RESULTS
  A total of 120 mothers and their 123 newborns were included. Prenatal treatment consisted of spiramycin in 43 mothers (35%), spiramycin/cotrimoxazole in 70 (56.9%) and pyrimethamine/sulfonamide in 10 (8.1%). A trend toward reduction in toxoplasmosis transmission was found when Sp/C was compared with Pyr/Sul and particularly with Spy alone (P=0.014). In particular, Spy increased the risk of congenital infection when compared with Sp/C (odds ratio (OR) 4.368; 95% CI: 1.253 to 15.219), but there was no significant reduction when Sp/C was compared with Pyr/Sul (OR 1.83; 95% CI: 0.184 to 18.274).
  
  
  CONCLUSIONS
  The treatment based on Sp/C has significant efficacy in reducing maternal-fetal transmission of Toxoplasma gondii when compared with Pyr/Sul and particularly to Spy. Randomized controlled trials would be required.
authors.affiliation: Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Valentini
authors.affiliation: Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Buonsenso
authors.affiliation: Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barone
authors.affiliation: Department of Pediatrics, Meyer Pediatric Hospital, Florence, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Serranti
authors.affiliation: Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Calzedda
authors.affiliation: Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ceccarelli
authors.affiliation: Department of Microbiology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Speziale
authors.affiliation: Department of Microbiology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Ricci
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Masini
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007558:Italy; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy / Q000469:parasitology; D011295:Prenatal Care / Q000379:methods; D011739:Pyrimethamine / Q000008:administration & dosage*; D012189:Retrospective Studies; D015572:Spiramycin / Q000008:administration & dosage*; D000077145:Sulfanilamide; D013424:Sulfanilamides / Q000008:administration & dosage*; D014122:Toxoplasma / Q000187:drug effects / Q000302:isolation & purification; D014123:Toxoplasmosis / Q000188:drug therapy / Q000469:parasitology / Q000635:transmission; D014125:Toxoplasmosis, Congenital / Q000517:prevention & control*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage*
chemical_list: D000890:Anti-Infective Agents; D004338:Drug Combinations; D013424:Sulfanilamides; D000077145:Sulfanilamide; D015572:Spiramycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011739:Pyrimethamine