Systematic review and meta-analysis on efficacy of cefixime for treating gonococcal infections

  • Syed Bilal Tanvir Dar Al Uloom University, College of Dentistry, Riyadh
  • Syed Saad Bin Qasim College of Dentistry, University of Oslo, Oslo, Norway
  • Ali Shariq College of Medicine , Qassim University, Buraidah, Saudi Arabia
  • Shariq Najeeb Bow River dental, Calgary, Alberta, Canada
  • Altaf H. Shah Dar Al Uloom University, Riyadh ,Saudi Arabia
Keywords: Cefixime, efficacy,, meta-analysis,, Neisseria gonorrhea,, sexually transmitted disease, sexually transmitted infections, systematic review

Abstract

Background: Neisseria gonorrhea is known to have developed a high level of resistance against different classes of antimicrobials. Patients with coagulation disorders where intramuscular injections are contraindicated, oral cefixime in combination therapy can be utilized as an alternative regimen. Cefixime in combination with another macrolide might be considered as an alternative treatment option. The aim of this systematic review is to assess the efficacy of 400 mg cefixime against a range of comparator drugs.

Methodology: Extensive literature search for randomized controlled trials was performed using Medline, Cochrane Registry of Controlled Trials, Embase, and Clinical trials registers. The trials assessed the efficacy of cefixime against a range of comparator drugs. Primary outcome of the study was the clinical resolution of signs and symptoms and negative culture at the end of follow-up period.

Results: After screening for a total of 1184, only 8 studies were eligible for a meta-analysis. Risk ratio random effects model was used with a 95% confidence interval (CI). The pooled efficacy of Cefixime was at 97% at 95 CI 1.01 (0.98, 1.05). No statistically significant difference was found between oral cefixime and comparator drugs.

Conclusion: A total of 11 studies were included following a review of 1184 publications. 8 randomized controlled trials for 400 mg oral cefixime were included in meta-analysis. Despite a high grade of evidence, a high risk of bias was found among studies. Hence, more high quality randomized controlled trials on cefixime needs to be performed in future to guide the treatment of gonococcal infections.

Author Biographies

Syed Bilal Tanvir, Dar Al Uloom University, College of Dentistry, Riyadh

Lecturer and Course Director,Department of Basic Medical Sciences

Syed Saad Bin Qasim, College of Dentistry, University of Oslo, Oslo, Norway

Postdoctoral Research Fellow Department of Biomaterials,

Ali Shariq, College of Medicine , Qassim University, Buraidah, Saudi Arabia

Assistant Professor,Department of Clinical Microbiology 

Shariq Najeeb, Bow River dental, Calgary, Alberta, Canada

Research Associate, Bow River dental

Altaf H. Shah, Dar Al Uloom University, Riyadh ,Saudi Arabia

Associate Professor, Department of Preventive Dental Sciences

Published
2018-08-14
How to Cite
Tanvir, S., Qasim, S., Shariq, A., Najeeb, S., & Shah, A. (2018). Systematic review and meta-analysis on efficacy of cefixime for treating gonococcal infections. International Journal of Health Sciences, 12(5). Retrieved from https://ijhs.org.sa/index.php/journal/article/view/3270
Section
Reviews