Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy

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.study design:retrospective study of pregnant women evaluated for suspected toxoplasmosis between 1992 and 2011.result: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).conclusion: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.