학술논문
Insights Into Treatment Alternatives for Neurosyphilis: Systematic Literature Review and Meta-Analysis.
Document Type
Academic Journal
Author
Callado GY; From the Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Pardo I; From the Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Gutfreund MC; From the Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Deliberato RO; Holubar M; Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, CA.; Salinas JL; Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, CA.; Marra CM; Department of Neurology, University of Washington School of Medicine, Seattle, WA.; Perencevich EN; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.; Marra AR
Source
Publisher: J B Lippincott Country of Publication: United States NLM ID: 7705941 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-4521 (Electronic) Linking ISSN: 01485717 NLM ISO Abbreviation: Sex Transm Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Abstract: We conducted a systematic literature review and meta-analysis to assess the efficacy of alternative treatments for neurosyphilis. We searched MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane, Scopus, and Web of Science from database inception to September 2023, for studies in neurosyphilis that compared penicillin monotherapy with other treatments. We focused on the impact of these therapies on treatment response, but also assessed data regarding reinfection and adverse drug events. Random-effect models were used to obtain pooled mean differences. Of 3415 screened studies, 6 met the inclusion criteria for the systematic literature review. Three studies provided quantitative data that allowed for inclusion in the meta-analysis. Our analysis revealed that the efficacy of intravenous (IV) ceftriaxone 2 g daily for 10 days (51 patients) did not appear statistically different compared with IV penicillin G 18 to 24 million units daily for 10 days (185 patients) for neurosyphilis (pooled odds ratio, 2.85; 95% confidence interval, 0.41-19.56; I 2 = 49%). No statistical difference between ceftriaxone and penicillin was identified in people living with human immunodeficiency virus (HIV) (pooled odds ratio, 4.51; 95% confidence interval, 0.50-40.49; I 2 = 34%). We concluded that alternative therapy with IV ceftriaxone appears similar to penicillin, potentially expanding treatment options for neurosyphilis. Other treatment options including doxycycline warrant further study.
Competing Interests: Conflicts of Interest: None declared.
(Copyright © 2024 American Sexually Transmitted Diseases Association. All rights reserved.)
Competing Interests: Conflicts of Interest: None declared.
(Copyright © 2024 American Sexually Transmitted Diseases Association. All rights reserved.)