From the Keck School of Medicine, University of Southern California.
Department of Medicine, University of California Los Angeles, Los Angeles.
Sex Transm Dis. 2023 Mar 1;50(3):131-137. doi: 10.1097/OLQ.0000000000001742. Epub 2022 Dec 13.
To treat Neisseria gonorrhoeae infection, the Centers for Disease Control and Prevention recommends a single oral dose of cefixime as an alternative to injectable ceftriaxone.
We conducted a systematic review and meta-analysis to describe the effectiveness of cefixime in treating N. gonorrhoeae infection at 3 different anatomic sites.We searched PubMed and Embase database to abstract treatment success rates and cefixime dosage/frequency for studies that reported the anatomical site of infection. We included reports published between January 1, 1980, and December 7, 2021. Twenty studies published between 1989 and 2015 were included in our meta-analysis. We calculated pooled treatment success percentages and 95% confidence intervals (CIs) using random-effects models.
Of patients who received a 400-mg single dose of cefixime, 824 of 846 (97%; 95% CI, 96%-98%) patients with urogenital infection, 107 of 112 (97%; 95% CI, 84%-100%) patients with rectal infection, and 202 of 242 (89%; 95% CI, 76%-96%) patients with pharyngeal infection were cured. Of patients who received an 800-mg single dose of cefixime, 295 of 301 (98%; 95% CI, 96%-99%) patients with urogenital infection and 21 of 26 (81%; 95% CI, 61%-92%) patients with pharyngeal infection were cured.
Our meta-analysis found that cefixime is highly effective at treating urogenital infections and less effective at treating pharyngeal infections. We recommend more investigation into the effectiveness of cefixime in treating rectal infections and studying multidose therapy for the cefixime treatment of pharyngeal infection.
为治疗淋病奈瑟菌感染，疾病控制与预防中心推荐使用单次口服头孢克肟作为注射用头孢曲松的替代药物。
我们进行了一项系统评价和荟萃分析，以描述头孢克肟治疗 3 个不同解剖部位淋病奈瑟菌感染的疗效。我们检索了 PubMed 和 Embase 数据库，以提取报告感染解剖部位的研究中的治疗成功率和头孢克肟剂量/频率。我们纳入了 1980 年 1 月 1 日至 2021 年 12 月 7 日期间发表的报告。我们的荟萃分析纳入了 1989 年至 2015 年期间发表的 20 项研究。我们使用随机效应模型计算了汇总的治疗成功率百分比和 95%置信区间（CI）。
接受 400mg 单剂量头孢克肟治疗的患者中，846 例泌尿生殖道感染患者中 824 例（97%；95%CI，96%-98%）、112 例直肠感染患者中 107 例（97%；95%CI，84%-100%）、242 例咽感染患者中 202 例（89%；95%CI，76%-96%）治愈。接受 800mg 单剂量头孢克肟治疗的患者中，301 例泌尿生殖道感染患者中 295 例（98%；95%CI，96%-99%）、26 例咽感染患者中 21 例（81%；95%CI，61%-92%）治愈。
我们的荟萃分析发现，头孢克肟治疗泌尿生殖道感染非常有效，治疗咽感染效果较差。我们建议进一步研究头孢克肟治疗直肠感染的疗效，并研究头孢克肟治疗咽感染的多剂量疗法。
