Treating gonococcal infections resistant to penicillin in Bangkok: comparison of cefuroxime and spectinomycin.

Chitwarakorn, Anupong; Ariyarit, C; Panikabutra, K; Buateing, Anukul; Biddle, James W.; Thompson, Sumner E.; Brown, Stuart T.

doi:10.1136/sti.61.5.306

Cited by 9 publications

(2 citation statements)

References 19 publications

(8 reference statements)

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“…Twenty-five studies used intramuscular injection monotherapy that involved 6422 patients and compared the efficacy of 12 different drugs . Nineteen of these studies reported adverse reactions in 569 patients and the safety of 11 drugs was assessed [27][28][29][30][31][32][33][34][36][37][38][39][40][41][44][45][46]49,50]. Similarly, 19 studies focused on oral monotherapy [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70].…”

Section: Literature Search Process and Study Characteristicsmentioning

confidence: 99%

Efficacy and Safety of Injectable and Oral Antibiotics in Treating Gonorrhea: A Systematic Review and Network Meta-Analysis

Yang

Dhital

Naderer

2019

JCM

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Gonorrhea is the second most frequently reported sexually transmitted infectious disease of bacterial origin in the world. Current empiric therapies rely on broad-spectrum antibiotics. However, treatment options are becoming limited due to the rise of drug-resistant gonorrhea. To control the rise of drug-resistant gonorrhea and to identify alternative treatment options, clinicians will have to increasingly rely on experimental evidence for the treatment of gonorrhea patients. Thus, we performed a systematic review and network meta-analysis of all randomized clinical trials about the efficacy and safety of various antibiotic regimens in adults with gonorrhea. We searched all references in Embase and PubMed from the date of their inception to January 2019, and then an updated search was performed in March 2019. Of the 28,843 identified references, 44 fulfilled our selection criteria. We used a network meta-analysis based on a frequentist approach to evaluate the efficacy and safety of 12 injectable and 11 oral antibiotics. The efficacy of treatments was ranked by p score and inconsistency was assessed by a back-calculation method. Certainty of evidence was evaluated by the GRADE system. For injectable drugs, there was no difference in efficacy between a reference antibiotic and other drugs. However, ceftriaxone had significantly better efficacy than cefuroxime (OR, 12.03; cephaloridine (OR, 42.41; kanamycin (OR, 5.45; penicillin (OR, 13.11;, and spectinomycin (OR, 4.70; 95% CI 1.62-13.62). Thus, ceftriaxone was the most effective injectable drug (p score of 0.924). As for oral drugs, azithromycin was the most effective compound (p score of 0.8633). There were no significant differences in safety between injectable and oral treatments. In our systematic review of randomized controlled trials, we found azithromycin and ceftriaxone to be the most effective antibiotics for the treatment of gonorrhea. This is in line with current guidelines which recommend a combination therapy of azithromycin and ceftriaxone for the treatment of gonorrhea due to increased antimicrobial resistance. Our analysis identified gentamicin and ofloxacin as alternative therapeutics to treat drug-resistant gonorrhea.

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Section: Literature Search Process and Study Characteristicsmentioning

confidence: 99%

Efficacy and Safety of Injectable and Oral Antibiotics in Treating Gonorrhea: A Systematic Review and Network Meta-Analysis

Yang

Dhital

Naderer

2019

JCM

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“…Infection caused by penicillinase‐producing Neisseria gonorrhoeae (PPNG) is endemic in many parts of the world 1 . Even in areas where PPNG infection is uncommon, penicillin resistance due to non‐penicillinase‐producing strains of gonococci is encountered increasingly.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of ceftizoxime in the treatment of uncomplicated gonorrhoea: comparison with amoxycillin

Veeravahu

et al. 1990

Int J Clinical Practice

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SummaryFour centres contributed a total of 466 patients to a study comparing the efficacy of oral amoxycillin with that of probenecid and intramuscular ceftizoxime. Both treatments were equally efficacious, except in the small number of penicillinase‐producing Neisseria gonorrhoeae patients, all of whom responded to ceftizoxime and none to amoxycyllin. Both treatments were well tolerated, the only two adverse effects occurring in the ceftizoxime group.

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Treatment of Uncomplicated Infections due to Neisseria gonorrhoeae

Rice¹

1986

JAMA

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Treating gonococcal infections resistant to penicillin in Bangkok: comparison of cefuroxime and spectinomycin.

Cited by 9 publications

References 19 publications

Efficacy and Safety of Injectable and Oral Antibiotics in Treating Gonorrhea: A Systematic Review and Network Meta-Analysis

Efficacy and Safety of Injectable and Oral Antibiotics in Treating Gonorrhea: A Systematic Review and Network Meta-Analysis

Efficacy of ceftizoxime in the treatment of uncomplicated gonorrhoea: comparison with amoxycillin

Treatment of Uncomplicated Infections due to Neisseria gonorrhoeae

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