title: Meta-analysis of ceftriaxone compared with penicillin for the treatment of syphilis.
abstract: Penicillin is the gold standard for treating syphilis. However, allergic reactions, poor drug tolerance and limited efficacy in patients remain a challenging problem. The objective of this meta-analysis was to compare the efficacy of ceftriaxone and penicillin based on data obtained from published randomised controlled trials (RCTs). The Cochrane Library, Medline, EBSCO, EMBASE and Ovid databases were searched for RCTs of ceftriaxone vs. penicillin for the treatment of syphilis. Estimated risk ratios (RRs) and 95% confidence intervals (CIs) were used to investigate the following outcome measures: 3-month response rate; 6-month response rate; 12-month response rate; relapse rate; serofast rate; and failure rate. Seven RCTs involving 281 participants (159 patients who received ceftriaxone and 122 patients who received penicillin) were included in the meta-analysis. There were no significant differences in 3-month response rate (RR=1.12, 95% CI 0.89-1.42), 6-month response rate (RR=1.02, 95% CI 0.75-1.38), 12-month response rate (RR=1.04, 95% CI 0.82-1.32), relapse rate (RR=0.91, 95% CI 0.45-1.84), serofast rate (RR=0.69, 95% CI 0.22-2.12) or failure rate (RR=0.66, 95% CI 0.03-15.76) in patients treated with ceftriaxone compared with those treated with penicillin. In conclusion, there is no evidence in the literature that ceftriaxone is less efficient than penicillin.
authors.affiliation: Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Oncology, Yancheng City No. 1 People's Hospital, Yancheng 224000, China.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Chen
authors.affiliation: Department of Dermatology, Affiliated Huai'an Hospital of Xuzhou Medical College, Huai'an 223002, China.
authors.forename: Chun-Sheng
authors.initials: CS
authors.lastname: Yang
authors.affiliation: Department of Radiotherapy, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Urologic Surgery, Yancheng City No. 1 People's Hospital, Yancheng 224000, China.
authors.forename: Xiao-Xiao
authors.initials: XX
authors.lastname: Jiang
authors.affiliation: Department of Stereotactic Radiosurgery, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China.
authors.forename: Xi-Feng
authors.initials: XF
authors.lastname: Xu
authors.affiliation: Department of Stereotactic Radiosurgery, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China.
authors.forename: Shou-Xin
authors.initials: SX
authors.lastname: Feng
authors.affiliation: Department of Dermatology, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China.
authors.forename: Yan-Qun
authors.initials: YQ
authors.lastname: Liu
authors.affiliation: Department of Dermatology, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China; Center for Disease Control and Prevention of Xuzhou City, Xuzhou 221006, Jiangsu Province, China. Electronic address: dr.guanjiang@gmail.com.
authors.forename: Guan
authors.initials: G
authors.lastname: Jiang
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013587:Syphilis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D002443:Ceftriaxone
keywords: Ceftriaxone; Meta-analysis; Penicillin; Randomised controlled trial; Syphilis