Infectious Diseases
Poster Session 1
.jpg "Daniel Martingano, DO MBA PhD photo")
Daniel Martingano, DO MBA PhD
OB/GYN Clerkship Director, Assistant Residency Program Director, Academic Chair of OB/GYN
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Marwah Al-Dulaimi, MD
Resident Physician, OB/GYN
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Andrea Ouyang, BS,MS
Medical Student
William Carey University College of Osteopathic Medicine
Baton Rouge, LA, United States
Sheida Rodriguez, DO
Resident
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Jessica Marshall, DO
Resident
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Rachel Amuzu, DO, MSc (she/her/hers)
Resident Physician, OB/GYN
Rutgers Health, Jersey City Medical Center
Bayonne, NJ, United States
Shavana Singh, BSc
Student Doctor, OMSIII
Lake Erie College of Osteopathic Medicine
Far Rockaway, PA, United States
Alexander Ulfers, DO
Resident Physician
Walter Reed National Military Medical Center
Bethesda, MD, United States
Jacqueline Marecheau, MD
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Benjamin Dribus, PhD
Chair, Department of Mathematics
William Carey University
Hattiesburg, MS, United States
Kristin Cohen, CNM, DNP
RWJBarnabas Health, Trinitas Regional Medical Center
Elizabeth, NJ, United States
Shailini Singh, MD
Attending Maternal-Fetal Medicine Specialist
Hackensack Meridian Health, JFK University Medical Center
Edison, NJ, United States
Donald Morrish, MD
Chief Medical Officer
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Antonia F. Oladipo, MD, MSCI (she/her/hers)
Assistant Professor
Hackensack University Medical Center
Hackensack, NJ, United States
In high-risk and underserved communities, treatment of otherwise uncommon diseases like toxoplasmosis for pregnant patients poses a significant challenge given limited medication availability, cost, and lack of subspecialty providers. This study sought to evaluate the safety and effectiveness of alternative antibiotic regimens in the treatment of toxoplasmosis for 2nd and 3rd trimesters.
Study Design:
We conducted a multicenter, prospective observational study from 7/2021 to 7/2023 comparing all pregnant patients who were diagnosed with toxoplasmosis in the 2nd or 3rd trimester and completed treatment. Patients were divided into two treatment groups: those who received pyrimethamine/leucovorin (PL) and those who received amoxicillin/clavulanic acid plus azithromycin (ACA). The treatment method was determined by medication availability, where the first attempt was always the preferred regimen through the Centers for Disease Control and Prevention. If there were barriers to obtaining such treatments, those patients were included in the alternative group. Patients were excluded if there was insufficient treatment compliance or immunosuppressive medical conditions. Primary outcomes included the resolution of maternal symptoms by physician clinical assessment, development of fetal hydrocephalus, clearance of maternal IgM serology, and 1 and 5-minute APGAR scores less than 7, as discrete events.
Results:
The study included 88 patients: 52 receiving PL regimens and 36 receiving ACA regimens. Baseline demographics, method of delivery, and rates of fetal hydrocephalus were not significantly different. Rates of treatment compliance were higher in the alternative regimen group (91.7% v. 88.5%, p = 0.002). Rates of fetal hydrocephalus, clearance of IgM, and APGAR scores were not significantly different. No adverse medication events were noted in either group.
Conclusion:
Amoxicillin/clavulanic acid plus azithromycin treatment regimens are safe and effective for toxoplasmosis in pregnancy, with potential added benefits for underserved populations, including decreased barriers to use and increased compliance.