Congenital Toxoplasmosis in Brazil: A Document Analysis of Government Guidelines for the Prescription and Medicine Use

Introduction: Congenital toxoplasmosis can result in severe clinical manifestations and long-term complications in newborns. Standard treatment typically comprises a combination of three medications, with the potential addition of a fourth temporarily. However, the lack of commercially available pediatric formulations in Brazil requires pharmacy compounding or alternative methods to adjust adult-dose tablets for neonatal use. Objective: This study aims to examine government guidelines on the prescription and use of medications for the treatment of congenital toxoplasmosis. Methods: Document analysis was used in this descriptive, qualitative, and exploratory study. Manual searches were conducted on the websites of Municipal Health Departments from all state capitals, State Health Departments, and the Ministry of Health portal. The inclusion criteria focused on documents containing guidelines for the prescription and/or use of medications for congenital toxoplasmosis. Medication information was compiled into a spreadsheet, detailing the source and specific government guidelines related to the prescription and/or use of medications for congenital toxoplasmosis. Results: The initial search yielded 1,640 documents. After screening, 1,615 were excluded based on the titles; 25 for detailed analysis were investigated. Of these, only five met the inclusion criteria. While all included documents provided information on the therapeutic regimen and dosage, only one addressed guideline for adapting adult tablets for newborns. This underscores the lack of relevant guidelines for the rational use of medicines and the need to ensure the expected therapeutic outcomes. Conclusion: This study underscores the urgency of establishing clearer and more comprehensive guidelines regarding the appropriate use of medications for treating toxoplasmosis in newborns in Brazil.