A fresh look at the role of spiramycin in preventing a neglected disease: meta-analyses of observational studies

Abstract

Purpose We aimed to investigate the effect of antepartum treatment with spiramycin with or without subsequent pyrimethamine–sulfonamide–folinic acid, compared to no treatment, on the rate of mother-to-child transmission (MTCT) of Toxoplasma gondii (T. gondii) and incidence/severity of sequelae in the offspring. Methods Embase and PubMed were searched for literature on spiramycin in pregnant women suspected/diagnosed with T. gondii infection. Meta-analyses were performed using random-effects model. Results Thirty-three studies (32 cohorts and 1 cross-sectional study), with a total of 15,406 mothers and 15,250 offspring, were pooled for analyses. The MTCT rate for all treated patients was significantly lower than the untreated [19.5% (95% CI 14–25.5%) versus 50.7% (95% CI 31.2–70%), p < 0.001]. The transmission rate in patients on spiramycin monotherapy was also significantly lower than untreated [17.6% (95% CI 9.9–26.8%) versus 50.7% (95% CI 31.2–70%), p < 0.001]. Conclusion Results indicate significant reduction in MTCT rates following spiramycin treatment of suspected/diagnosed maternal T. gondii infection.

Building Programs to Eradicate Toxoplasmosis Part I: Introduction and Overview

“…Herein, we present an introduction to, and an overview and review of work [ 1 ••, 2 , 3 ••, 4 ••, 5 ••, 6 ••, 7 ••, 8 ••, 9 ••, 10 ••, 11 ••, 12 , 13 , 14 ••, 15 ••, 16 ••, 17 ••, 18 •, 19 •, 20 •, 21 •, 22 •, 23 , 24 ••, 25 , 26 , 27 •, 28 •, 29 , 30 , 31 •, 32 •, 33 ••, 34 •, 35 •, 36 , 37 •, 38 •, 39 ••, 40 •, 41 •, 42 ••, 43 ••, 44 ••, 45 , 46 •, 47 ••, 48 ••, 49 , 50 •, 51 •, 52 •, 53 ••, 54 , 55 ••, 56 ••, 57 •, 58 ••, 59 •, 60 ••, 61 , 62 ••, 63 •, 64 ••, 65 , 66 ••, 67 ••, 68 ••, 69 , 70 , 71 ••, 72 ••, 73 •...…”

Anti-Inflammatory Effects of Spiramycin in LPS-Activated RAW 264.7 Macrophages

“…In this study, we confirmed the possibility of applying an old weapon, spiramycin, to various inflammatory diseases, the new enemy. Spiramycin has been shown to exhibit anti-bacterial, anti-viral, and anti-parasitic activities [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. However, no study has reported the anti-inflammatory potential of spiramycin in LPS-induced macrophage RAW 264.7 cells.…”

“…Spiramycin is a 16-membered ring macrolide antibiotic that was first discovered 70 years ago in a culture medium of Streptomyces ambofaciens in 1952 ( Figure 1 ). The antibiotic action of spiramycin, which inhibits protein synthesis in bacterial cells during translocation, has high antimicrobial activity against Gram-positive bacteria and mycoplasma species, and is widely used to treat toxoplasmosis and other soft-tissue infections in cattle, pigs, poultry, and sheep [ 6 , 7 , 8 ]. Spiramycin is prescribed in some countries for various odor-causing infections including periodontitis [ 9 , 10 ].…”

Building Programs to Eradicate Toxoplasmosis Part IV: Understanding and Development of Public Health Strategies and Advances “Take a Village”

“…Part IV considers briefly the foundation to which these studies contribute, providing a rationale and framework for extending the studies. This includes additional basic science and translational work and needed improvements in clinical care [ 1 ••, 2 , 3 ••, 4 ••, 5 ••, 6 ••, 7 ••, 8 ••, 9 ••, 10 ••, 11 ••, 12 , 13 , 14 ••, 15 ••, 16 ••, 17 ••, 18 •, 19 •, 20 •, 21 •, 22 •, 23 , 24 ••, 25 , 26 , 27 •, 28 •, 29 – 30 , 31 •, 32 •, 33 ••, 34 •, 35 •, 36 , 37 •, 38 •, 39 ••, 40 •, 41 •, 42 ••, 43 ••, 44 ••, 45 , 46 •, 47 ••, 48 ••, 49 , 50 •, 51 •, 52 , 53 ••, 54 , 55 ••, 56 ••, 57 •, 58 ••, 64.•• ••, 68 ••, 88 ••, 89 ••, 90 , 91 , 92 ••, 93 , 94 , 118 ••, 124 , 125 …”