Systematic Review and Meta-Analysis of Doxycycline Efficacy for Rectal Lymphogranuloma Venereum in Men Who Have Sex with Men.

Abstract

Rectal lymphogranuloma venereum (LGV) has reemerged as a sexually transmitted infection among men who have sex with men (MSM), particularly those who are HIV-positive. We undertook a systematic review and meta-analysis to determine the efficacy of doxycycline (100 mg 2×/d for 21 days) for rectal LGV in MSM. Nine studies were included: 4 prospective, 4 retrospective, and 1 combined retrospective and prospective. In total, 282 MSM with rectal LGV were included in the studies. All studies reported using nucleic acid amplification tests to assess microbial cure. Most patients (>80%) had symptomatic rectal infection. The fixed-effects pooled efficacy for doxycycline was 98.5% (95% CI 96.3%-100%, I (2)  = 0%; p = 0.993). Doxycycline at 100 mg twice daily for 21 days demonstrated a high microbial cure rate. These data support doxycycline at this dosage and duration as first-line therapy for rectal LGV in MSM.

• Authors: Charussri Leeyaphan, Jason J Ong, Eric P F Chow, Fabian Y S Kong, Jane S Hocking, Melanie Bissessor, Christopher K Fairley, Marcus Chen
• Journal: Emerging infectious diseases (Emerg Infect Dis) Vol. 22 Issue 10 Pg. 1778-84 (10 2016) ISSN: 1080-6059 [Electronic] United States
• PMID: 27513890 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Anti-Bacterial Agents
• Doxycycline

Topics

• Anti-Bacterial Agents (therapeutic use)
• Chlamydia trachomatis
• Doxycycline (therapeutic use)
• Homosexuality, Male
• Humans
• Lymphogranuloma Venereum (drug therapy)
• Male
• Rectal Diseases (drug therapy)
• Treatment Outcome