{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:01:52Z","timestamp":1789084912019,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"STD"},{"name":"PCHD","award":["PS19-1901"],"award-info":[{"award-number":["PS19-1901"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Guidelines recommend that pregnant patients with syphilis of late\/unknown duration be treated with benzathine penicillin G, dosed as 3 weekly intramuscular injections (BPGx3) given ideally at strict 7-day intervals. Given limited pharmacokinetic data, it is unknown whether more flexible BPG treatment intervals might be effective in preventing congenital syphilis (CS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used California surveillance data to identify birthing parent\/infant dyads wherein the pregnant parent had syphilis of late\/unknown duration between January 1, 2016 \u2013 June 30, 2019. We divided the dyads into 3 groups based on prenatal treatment: (1) BPGx3 at strict 7-day intervals, (2) BPGx3 at 6-8 day intervals, and (3) no\/inadequate treatment. We then compared CS incidence among infants in each group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We analyzed 1,092 parent\/infant dyads: 607 (55.6%) in the 7-day treatment group, 70 (6.4%) in the 6\u20138 day treatment group, and 415 (38.0%) in the no\/inadequate treatment group. The incidence proportion of infants meeting CS criteria in each group was, respectively, 5.6%, 5.7%, and 36.9%. Compared with BPGx3 at 7-day intervals, the odds of CS were 1.0 [95% CI 0.4\u20133.0] in the 6\u20138 day group and 9.8 [95% CI 6.6\u201314.7] in the no\/inadequate treatment group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Prenatal BPGx3 at 6\u20138 days was no more likely to lead to CS in infants than 7-days. These findings hint that 6-8-day intervals might be adequate to prevent CS among pregnant people with syphilis of late\/unknown duration. Consequently, it is possible that CS evaluation beyond an RPR at delivery may be unnecessary in asymptomatic infants whose parents received BPGx3 at 6\u20138 days.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad300","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T13:40:14Z","timestamp":1686231614000},"source":"Crossref","is-referenced-by-count":3,"title":["Comparing 7-Day Versus 6\u20138-Day Penicillin Treatment Intervals Among Pregnant People With Syphilis of Late or Unknown Duration: No Difference Found in Incidence of Congenital Syphilis"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3333-099X","authenticated-orcid":false,"given":"Kelly A","family":"Johnson","sequence":"first","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health , Richmond, California , USA"},{"name":"Department of Medicine, Division of Infectious Diseases, University of California San Francisco , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole O","family":"Burghardt","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E","family":"Snyder","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalyn E","family":"Plotzker","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health , Richmond, California , USA"},{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon M","family":"Imp","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kaiser Permanente San Francisco Medical Center , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Murphy","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8615-7708","authenticated-orcid":false,"given":"Eric C","family":"Tang","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,8]]},"reference":[{"key":"2023062808132781600_ofad300-B1","author":"Centers for Disease Control and Prevention"},{"key":"2023062808132781600_ofad300-B2","author":"California Department of Public Health STD Control Branch"},{"key":"2023062808132781600_ofad300-B3","author":"Centers for Disease Control and Prevention"},{"key":"2023062808132781600_ofad300-B4","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1097\/OLQ.0000000000000846","article-title":"Congenital syphilis prevention: strategies, evidence, and future directions","volume":"45","author":"Plotzker","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2023062808132781600_ofad300-B5","first-page":"203","article-title":"Congenital syphilis: a U.S. Perspective","volume":"7","author":"Galvis","year":"2020","journal-title":"Children (Basel)"},{"key":"2023062808132781600_ofad300-B6","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.ajog.2016.11.1052","article-title":"Syphilis during pregnancy: a preventable threat to maternal-fetal health","volume":"216","author":"Rac","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"2023062808132781600_ofad300-B7","author":"Centers for Disease Control and Prevention"},{"key":"2023062808132781600_ofad300-B8","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1056\/NEJMc2111103","article-title":"High congenital syphilis case counts among U.S. Infants born in 2020","volume":"385","author":"Bowen","year":"2021","journal-title":"N Engl J Med"},{"key":"2023062808132781600_ofad300-B9","author":"Centers for Disease control and Prevention"},{"key":"2023062808132781600_ofad300-B10","doi-asserted-by":"crossref","first-page":"S818","DOI":"10.1093\/cid\/civ714","article-title":"Management of adult syphilis: key questions to inform the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines","volume":"61","author":"Ghanem","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2023062808132781600_ofad300-B11","author":"Centers for Disease Control and Prevention"},{"key":"2023062808132781600_ofad300-B12","author":"California Department of Public 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2014","volume":"45","author":"Biswas","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2023062808132781600_ofad300-B24","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/OLQ.0000000000000909","article-title":"Preventing congenital syphilis-opportunities identified by congenital syphilis case review boards","volume":"46","author":"Rahman","year":"2019","journal-title":"Sex Transm Dis"},{"key":"2023062808132781600_ofad300-B25","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.15585\/mmwr.mm6739a3","article-title":"Factors contributing to congenital syphilis cases\u2014New York City, 2010\u20132016","volume":"67","author":"Slutsker","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2023062808132781600_ofad300-B26","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1097\/OLQ.0000000000000638","article-title":"Effectiveness of prenatal screening and treatment to prevent congenital syphilis, Louisiana and Florida, 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