Dallé Jéssica, Ramos Mauro Cunha, Jimenez Mirela Foresti, Escobar Fernanda Garcia, Antonello Vicente Sperb
Department of Prevention and Infection Control, Hospital Fêmina, Porto Alegre, RS, Brazil.
Post-graduate Program in Obstetrics and Gynecology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Rev Bras Ginecol Obstet. 2018 Jan;40(1):43-46. doi: 10.1055/s-0037-1606274. Epub 2017 Aug 31.
Gestational syphilis is a prevalent disease in Brazil and other low and medium income countries. Desensitization to penicillin is recommended for pregnant women with syphilis who are allergic to β-lactams. This is a descriptive study utilizing outpatient medical records from 2011 to 2015 from a mother and child hospital that is part of the national healthcare system in the South of Brazil, which performs an average of 3,600 birth assistances per year. All cases of pregnant women with syphilis and presumptive diagnosis of β-lactam allergy during the study period were included. The patients referred for desensitization originated from the hospital prenatal care service, as well as from municipal/state antenatal care services. Oral desensitization was performed in the obstetric emergency room, and adult and pediatric intensive care units were available at all times. Ten patients underwent desensitization during the period of study. Personal history of urticaria was the most common reaction that demanded desensitization. All patients tolerated the procedure well, and showed no adverse reactions. We report a successful program of oral desensitization. None of the patients presented adverse reactions or complications, a fact that corroborates the feasibility and safety of the desensitization protocol. Oral administration of penicillin comes at a low cost, and optimizes the use of time and resources.
妊娠梅毒在巴西及其他中低收入国家是一种普遍存在的疾病。对于对β-内酰胺类药物过敏的梅毒孕妇，建议进行青霉素脱敏治疗。这是一项描述性研究，利用了巴西南部一家作为国家医疗体系一部分的妇幼医院2011年至2015年的门诊病历，该医院每年平均提供3600次分娩协助。研究纳入了研究期间所有梅毒孕妇及疑似β-内酰胺类药物过敏的病例。被转诊进行脱敏治疗的患者来自医院的产前护理服务以及市/州级产前护理服务。在产科急诊室进行口服脱敏治疗，且随时设有成人及儿科重症监护病房。在研究期间有10名患者接受了脱敏治疗。荨麻疹个人史是最常见的需要进行脱敏治疗的反应。所有患者对该治疗耐受良好，且未出现不良反应。我们报告了一项成功的口服脱敏治疗方案。没有患者出现不良反应或并发症，这一事实证实了脱敏方案的可行性和安全性。口服青霉素成本低廉，且优化了时间和资源的利用。
