Is sulfadiazine alone equivalent (benefit and harm) to spiramycin to treat acute toxoplasmosis in the first trimester of pregnancy?

Bernardo, Wanderley Marques; Chinzon, Miriam; Chaves, Felipe Galvão Batista

doi:10.1590/1806-9282.61.06.495

Cited by 3 publications

(6 citation statements)

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“…22 Positive PCR results in the amniotic fluid determine which patients require triple therapy. 17,23 The ultrasonographic alterations related to vertical transmission, which were only detected in two fetuses in the present study, were: cerebral ventriculomegaly and periventricular calcifications. The findings suggestive of fetal infection by T. gondii may arise during gestation, and have already been described in the literature.…”

Section: Discussionmentioning

confidence: 48%

“…Therefore, caution should be exercised when selecting which pregnant women will indeed benefit from the treatment, and they must be informed of the importance of taking folinic acid and seeking medical attention quickly if any side effects of the medications are identified. 13,14,23,38 The limitations of the present study are the small number of patients and the fact that information was obtained through the retrospective collection of data in medical records, rather than through prospective studies.…”

Section: Discussionmentioning

confidence: 94%

“…This drug is described in the literature as a therapeutic option, especially in immunocompromised patients, but more studies are necessary to validate this approach in pregnant women. 18,23,26,[33][34][35][36][37] Although infrequent, triple therapy may lead to serious complications. Prescribing these medications for all patients who become infected in the third trimester and do not perform the propaedeutic study for fetal research may increase the risk of adverse reactions in individuals who may not need these drugs.…”

Section: Discussionmentioning

confidence: 99%

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Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

Diesel

Záchia

Müller

et al. 2019

Rev Bras Ginecol Obstet

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Objective To describe a population of pregnant women diagnosed with toxoplasmosis and their respective newborns, describing the hospital protocol for treatment and follow-up. Methods Retrospective cohort of pregnant women with acute toxoplasmosis infection and risk of transplacental transmission who were sent to the Fetal Medicine Group of Hospital de Clínicas de Porto Alegre (HCPA) between -January 1, 2006 and December 31, 2016. All patients with confirmed disease were included. The diagnostic protocol and treatment were applied; a polymerase chain reaction (PCR) analysis of the amniotic fluid was used to diagnose toxoplasmosis and determine the treatment. The newborns were followed up at the pediatric outpatient clinic specializing in congenital infection. The patients who were not followed up or were not born in the HCPA were excluded. Results A total of 65 patients were confirmed to have gestational toxoplasmosis; 40 performed amniocentesis, and 6 (15%) were identified as having positive PCR in the amniotic fluid. In five of those cases, this result associated with the gestational age defined the triple therapy during pregnancy, and in one case, it defined the monotherapy (advanced gestational age). A total of 4 of these newborns were treated from birth with triple therapy for 10 months, 1 was not treated (due to maternal refusal), and 1 progressed to death within the first 54 hours of life due to complications of congenital toxoplasmosis. Of the 34 remaining cases with a negative PCR, 33 were treated with monotherapy and 1 was treated with triple therapy (ultrasound findings); of these children, 9 (26.5%) presented negative immunoglobulin G (IgG), 24 (70.6%) presented Ana Lúcia Letti Müller's ORCID is https://orcid.org/0000-0003-1214-5664.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

Diesel

Záchia

Müller

et al. 2019

Rev Bras Ginecol Obstet

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“…However, pyrimethamine, sulfadiazine, and folinic acid are administered in cases of suspected congenital infections. There are risks of adverse teratogenic and hematological effects, in addition to reactions that can also occur in the mother (Bernardo et al, 2015), as in Velter (2018), in which the development of SJS was verified in pregnant women after the administration of a combination of pyrimethamine and sulfadiazine.…”

Section: Resultsmentioning

confidence: 99%

“…There is no treatment to eradicate toxoplasmosis, as the available drugs have no effect on bradyzoite cysts that are Research, Society andDevelopment, v. 10, n. 13 e505101321339, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i13.21339 3 deposited in the host and can be reactivated later (Bernardo et al, 2015). The only available treatment is for tachyzoites.…”

Section: Introductionmentioning

confidence: 99%

Profile of adverse events in toxoplasmosis drug therapy: a review

Sousa

Viana

Caires

et al. 2021

RSD

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This study aims to analyze the profile of adverse events (AEs) of drugs for the treatment of Toxoplasmosis. This is a review carried out through a bibliographic search in the electronic databases PubMed, SciELO, Cochrane Digital Library and LILACS. The keywords “Toxoplasmosis” AND “Drug Therapy” AND “Drug-Related Side Effects and Adverse Reactions” were used. The selection was performed by two independent reviewers and the articles were included considering the presence of retrospective studies and case reports published in the literature in Portuguese and English and without time restrictions. In total, 40 articles were found, of which 14 met the inclusion criteria. Cases of cerebral, ocular, gestational and congenital Toxoplasmosis were identified. Among these, we observed a total of 85 patients with reports of AEs due to the use of Pyrimethamine, Sulfadiazine, Spiramycin, Clindamycin, Atovaquone, Trimethoprim and Sulfamethoxazole and Sulfadoxine. Clinical reactions were in the form of skin rash (57.1%), hematological alterations (28.5%), Lyell syndromes (7.1%), Stevens-Johnson (21.4%) and DRESS (21 .4%). The prevalence of AEs related to hematological alterations was seen mainly in treatments based on Pyrimethamine + Sulfadiazine, Trimethoprim and Sulfamethoxazole; on the other hand, those associated with severe syndromes are often related to the use of Pyrimethamine + Sulfadiazine. It is important to establish a standard protocol for drug therapy for Toxoplasmosis, which does not yet exist. In addition, the need to monitor patients after drug administration is highlighted, given the possibility of the occurrence of adverse events that can represent a threat to life.

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2023

J. Med. Chem. Sci.

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Toxoplasmosis is a well-known and widespread parasite infection. Although diagnosis has come a long way, therapeutic approaches have not changed since the 1940s. Using SOCl2/EtOH as a catalyst, the Claisen-Schmidt condensation method has been used in this study to effectively synthesize chalcone. The anti-parasitic effect of the synthesized chalcone was evaluated at doses of 1, 10, 50, 100, 250, 500, and 1000 μg/ml against isolated Toxoplasma Gondii from aborted cases compared with spiramycin. The isolated T. Gondii in this therapeutic investigation was used as strong positive specimens for inoculum on Vero cells for parasite propagation. A significant reduced the fold expression values (2^-∆∆CT), which are a measure of how well chalcone inhibits the proliferation of parasites. Compared with spiramycin, which demonstrated an IC50 of 281.19 g/mL, chalcone has an inhibitory concentration (IC50) of 142.9 μg/mL. The results of this study reveal that chalcone can be used as a medication to treat toxoplasmosis because it had an antiparasitic impact on T. Gondii. To assess the therapeutic index of chalcone, molecular, synergistic, and in vivo monitoring investigations are essential.

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Is sulfadiazine alone equivalent (benefit and harm) to spiramycin to treat acute toxoplasmosis in the first trimester of pregnancy?

Abstract: is sulFadiazine alone equivalent (BeneFit and harM) to sPiraMyCin to treat aCute toxoPlasMosis in the First triMester oF PreGnanCy? rev assoC Med Bras 2015; 61(6):495-496 495AT BEDSIDE

Cited by 3 publications

References 6 publications

Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

Profile of adverse events in toxoplasmosis drug therapy: a review

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