Japanese

Title	妊娠中の梅毒治療にアモキシシリン内服を行った母から出生した児6例
Subtitle	症例報告
Authors	吉馴亮子1), 武藤はる香2), 楠本裕紀2), 新堂真利子2), 石田絵美2), 島田勝子2), 山枡誠一2)
Authors (kana)
Organization	1)阪南中央病院小児科, 2)産婦人科
Journal	日本周産期・新生児医学会雑誌
Volume	58
Number	3
Page	561-566
Year/Month	2022 / 12
Article	報告
Publisher	日本周産期・新生児医学会
Abstract	「概要」 梅毒合併妊婦にペニシリン(PC)治療を行うことで先天梅毒を防止する. 世界的にはPC筋肉注射治療だが, 日本では1950年代にPC筋肉注射による死亡事例を機にPC製剤の筋肉注射が難しく, 経口PC薬のアモキシシリン(AMPC)を治療薬として使用している. このAMPC治療母体から出生した児に関する報告は少ない. 今回, 2016〜2020年まで当院妊婦健診中にAMPC治療を受けた梅毒合併妊婦とその出生児6例を検討した. 5例は妊娠15週までに, 1例は妊娠22週からAMPC治療が開始された. 全例AMPC 1,500mg内服, 内服期間の中央値は7.5週(6-12週). 全例分娩1カ月以上前に内服を終了した. 母治療前後の非特異的トレポネーマ(RPR)は5例で, 1/4以上低減したが1例だけ低減せず児へPCG治療を行った. 先天梅毒と診断された児はおらず梅毒合併妊婦へのAMPC治療は先天梅毒を防ぐ可能性が示された.
Practice	臨床医学：外科系
Keywords	syphilis, amoxicillin, pregnant women, congenital syphilis

English

Title	Newborn outcomes among pregnant women with oral amoxicillin treatment for syphilis
Subtitle
Authors	Ryoko Yoshinare1), Haruka Mutou2), Yuki Kusumoto2), Mariko Shindou2), Emi Ishida2), Katsuko Shimada2), Seiichi Yamamasu2)
Authors (kana)
Organization	1)Department of Pediatrics, Hannan Chuo Hospital, 2)Department of Obstetrics and Gynecology, Hannan Chuo Hospital
Journal	Journal of Japan Society of Perinatal and Neonatal Medicine
Volume	58
Number	3
Page	561-566
Year/Month	2022 / 12
Article	Report
Publisher	Japan Society of Perinatal and Neonatal Medicine
Abstract	Congenital syphilis can be prevented by penicillin treatment of pregnant women with syphilis. Benzathine penicillin G is used worldwide, but it is difficult to use in Japan, because of following a fatal case of intramuscular penicillin injection in the 1950s, so, amoxicillin, an oral penicillin drug, is commonly used for the treatment of pregnant women with syphilis. There are few reports on infants born to pregnant women treated with amoxicillin. In this study, we examined six pregnant women with syphilis and their newborns who were treated with amoxicillin during antenatal care at our hospital from 2016.1. to 2020.12. Five patients were started on amoxicillin by 15 weeks of gestation, and one patient was first diagnosed at 21 weeks of gestation, so amoxicillin was started at 22 weeks of gestation. All of them received treatment of amoxicillin 1,500 mg/day and the median duration of administration was 7.5 weeks (6-12 weeks), and all cases were completed the administration 1 month before the delivery. In five pregnant women, the rapid plasma regain (RPR) titer, as nontreponemal antibodies, after amoxicillin treatment decreased more than a quarter compared with the pre-treatment RPR, but only one case did not show a quarter decrease. In all cases, the newborn's RPR titer at birth was reduced to more than a quarter of the mother's RPR titer at delivery. However, penicillin G treatment was administered to newborn whose RPR titer did not decrease by more than a quarter before and after the mother's treatment. There were no cases of congenital syphilis diagnosed in all patients. Amoxicillin treatment of pregnant women with syphilis may be expected to prevent congenital syphilis.
Practice	Clinical surgery
Keywords	syphilis, amoxicillin, pregnant women, congenital syphilis

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