{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:02:26Z","timestamp":1778518946022,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Toxoplasmosis is a parasitic infection caused by <jats:italic>Toxoplasma gondii<\/jats:italic> and is responsible for gestational and congenital infections worldwide. The current standard therapy is based on the administration of Spiramycin to prevent trans\u2010placental transmission. Other therapies are being studied to reduce the rates of foetal transmission and symptomatic congenital infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We report our long\u2010standing experience in maternal toxoplasmosis infection treatment using a combination of Spiramycin\u2013Cotrimoxazole, assessing its effectiveness in preventing vertical transmission compared to the expected incidence of congenital infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively collected cases of pregnant women referred to our centre for suspected toxoplasmosis infection according to Lebech criteria, treated with Spiramycin\u2013Cotrimoxazole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1364 women referred to our centre, postnatal follow\u2010up of primary toxoplasmosis was available in 562 cases (73.9%). The overall vertical transmission rate was 3.4% in women treated immediately with Spiramycin\u2013Cotrimoxazole after the diagnosis of infection. In comparison, it was 7.7% in women undergoing the same therapy but late or with poor compliance. The foetal transmission rate was 71.4% in untreated cases. All the infected newborns of mother treated adequately with Spiramycin\u2013Cotrimoxazole were asymptomatic afterbirth, while 6\/21 infected infants of the inadequate Spiramycin\u2013Cotrimoxazole therapy group had postnatal sequelae (28.5%). The incidence of transmission after appropriate Spiramycin\u2013Cotrimoxazole therapy was significantly lower than the expected rate reported in literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A combination of Spiramycin and Cotrimoxazole is safe and effective in preventing foetal congenital toxoplasmosis and reducing sequelae in case of in\u2010utero infection. The timing and adherence to the therapy are crucial to lowering the risk of congenital infection and neonatal morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.14021","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T13:53:30Z","timestamp":1717682010000},"page":"697-705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The prevention of congenital toxoplasmosis using a combination of Spiramycin and Cotrimoxazole: The long\u2010time experience of a tertiary referral centre"],"prefix":"10.1111","volume":"29","author":[{"given":"Marco","family":"De Santis","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica Fondazione Policlinico Universitario A. 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