Ceftriaxone in the treatment of early syphilis: a systematic review and meta-analysis / 中华皮肤科杂志

ABSTRACT

Objective To retrieve clinical evidence for the efficacy of ceftriaxone in the treatment of early syphilis.Methods Several international and national medical databases were used to search original articles published from 1985 to 2012 and reporting the efficacy of ceftriaxone or penicillin for the treatment of early syphilis.Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were identified and retrieved.The quality of studies was assessed using the Jadad scale.Eligible studies were selected according to an established strategy.A meta-analysis was performed by the Stata software version 12.0.Results A total of 14 RCTs or CCTs were eligible for this meta-analysis,including five high-quality trials.Response rate ratios were calculated for ceftriaxone-treated patients compared with penicillin-treated patients.The meta-analysis showed no significant difference in the efficacy between ceftriaxone and penicillin at 6-,12-and 24-month follow-up visits.The response rate was 92.3％ (95％ CI88.5％-96.1％) and 90.4％ (95％ CI87.4％-94.4％) in ceftriaxone-and penicillintreated patients respectively at the 12-month follow-up visit.Funnel plots were approximately symmetrical,indicating little publication bias.Conclusions Ceftriaxone may serve as an alternative treatment for early syphilis with reliable efficacy.However,multi-centered RCTs with large sample sizes are still needed to optimize the therapeutic dose and course of ceftriaxone for early syphilis.