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.
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Several different ceftriaxone regimens have been shown to be effective for the treatment of early syphilis.
“Several different ceftriaxone regimens have been shown to be effective for the treatment of early syphilis.104–113”
From BASHH UK guidelines for the management of syphilis 2024 (2024) · cites this paper as [112]
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- Authors
- Liang, Z., Chen, Y.-P., Yang, C.-S., Guo, W., Jiang, X.-X., Xu, X.-F., Feng, S.-X., Liu, Y.-Q., & Jiang, G.
- Affiliations
- Xuzhou Central Hospital (CN)
- Affiliated Hospital of Xuzhou Medical College (CN)
- Yancheng First People's Hospital (CN)
- Corresponding author
- Jiang, Xiao-Xiao
- Liu, Yan-Qun
- Jiang, Guan
- Venue
- International Journal of Antimicrobial Agents
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 47
- Issue
- 1
- Pages
- 6-11
- ISSN
- 0924-8579 (ISSN-L)
- OpenAlex
- W2207888755
- Cited by
- 44
- References
- 7
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 3 · 2020: 8 · 2019: 4 · 2018: 1 · 2017: 5 · 2016: 2
- FWCI
- 0.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Antimicrobial Agents (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
- Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
- Keywords
- ceftriaxone, penicillin, syphilis, antibiotic efficacy, treatment response rate, relapse, treatment failure, cephalosporins
- MeSH terms
- Anti-Bacterial Agents, Ceftriaxone, Humans, Penicillins, Recurrence, Syphilis, Randomized Controlled Trials as Topic, Treatment Outcome
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