Treatment of Acute Ocular Toxoplasmosis in Pregnancy — First Trimester

Acute ocular toxoplasmosis presenting during the first trimester of pregnancy requires a treatment strategy that accounts for gestational safety. The selection and sequencing of agents at this stage differs substantially from standard management outside of pregnancy.

This protocol applies to patients who are in the first trimester of pregnancy at the time of diagnosis. Gestational age is the primary determinant of which agents are appropriate: certain drugs used in classic regimens are considered teratogenic or may cause neonatal toxicity, making them unsuitable at this stage of gestation.

First-trimester management centres on a spiramycin-based combination selected for compatibility with early gestation — the complete regimen, dosing schedule, and alternatives are in the full protocol.