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Syphilis Treatment: Systematic Review and Meta-Analysis Investigating Nonpenicillin Therapeutic Strategies.
Callado, Gustavo Yano; Gutfreund, Maria Celidonio; Pardo, Isabele; Hsieh, Mariana Kim; Lin, Vivian; Sampson, Mindy Marie; Nava, Guillermo Rodriguez; Marins, Tássia Aporta; Deliberato, Rodrigo Octávio; Martino, Marinês Dalla Valle; Holubar, Marisa; Salinas, Jorge L; Marra, Alexandre R.
Afiliação
  • Callado GY; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
  • Gutfreund MC; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
  • Pardo I; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
  • Hsieh MK; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
  • Lin V; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
  • Sampson MM; Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, California, USA.
  • Nava GR; Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, California, USA.
  • Marins TA; Faculdade de Medicina, Centro Universitário de Adamantina, Adamantina, São Paulo, Brazil.
  • Deliberato RO; Department of Biomedical Informatics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
  • Martino MDV; Biomedical Informatics Division, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Holubar M; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
  • Salinas JL; Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, California, USA.
  • Marra AR; Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, California, USA.
Open Forum Infect Dis ; 11(4): ofae142, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38595955
ABSTRACT

Background:

Penicillin's long-standing role as the reference standard in syphilis treatment has led to global reliance. However, this dependence presents challenges, prompting the need for alternative strategies. We performed a systematic literature review and meta-analysis to evaluate the efficacy of these alternative treatments against nonneurological syphilis.

Methods:

We searched MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane, Scopus, and Web of Science from database inception to 28 August 2023, and we included studies that compared penicillin or amoxicillin monotherapy to other treatments for the management of nonneurological syphilis. Our primary outcome was serological cure rates. Random-effect models were used to obtain pooled mean differences, and heterogeneity was assessed using the I2 test.

Results:

Of 6478 screened studies, 27 met the inclusion criteria, summing 6710 patients. The studies were considerably homogeneous, and stratified analyses considering each alternative treatment separately revealed that penicillin monotherapy did not outperform ceftriaxone (pooled odds ratio, 1.66 [95% confidence interval, .97-2.84]; I2 = 0%), azithromycin (0.92; [.73-1.18]; I2 = 0%), or doxycycline (0.82 [.61-1.10]; I2 = 1%) monotherapies with respect to serological conversion.

Conclusions:

Alternative treatment strategies have serological cure rates equivalent to penicillin, potentially reducing global dependence on this antibiotic.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Open Forum Infect Dis Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Open Forum Infect Dis Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos