Efficacy and Safety of Antibiotics for the Treatment of Relapsing Fever: A Systematic Review and Network Meta-analysis

被引：0

作者：

Gao, Li ^{[1
]}

Wu, Xinya ^{[1
]}

Liu, Meixiao ^{[1
]}

Fan, Yuxin ^{[1
]}

Chen, Jingjing ^{[1
]}

Yang, Jiaru ^{[1
]}

Ma, Weijie ^{[1
]}

Zhong, Lei ^{[1
]}

Peng, Li ^{[1
]}

Wu, Hanxin ^{[1
]}

Kong, Jing ^{[1
]}

Li, Bingxue ^{[1
]}

Dong, Yan ^{[1
]}

Ma, Weijiang ^{[1
]}

Liu, Aihua ^{[1
,2
]}

Bao, Fukai ^{[1
,2
]}

机构：

[1] Kunming Med Univ, Inst Trop Med, Fac Basic Med Sci, 1168 Chunrong West Rd,YuhuaSt, Kunming 650500, Peoples R China

[2] Kunming Med Univ, Affiliated Children Hosp, Yunnan Prov Key Lab Childrens Major Dis Res, Kunming, Peoples R China

来源：

INFECTIOUS MICROBES & DISEASES | 2024年 / 6卷 / 03期

基金：

中国国家自然科学基金;

关键词：

relapsing fever; antibiotic treatment; efficacy; safety; network meta-analysis; GAMMA RELEASE ASSAYS; DOXYCYCLINE TREATMENT; TETRACYCLINE; TUBERCULOSIS; PROPHYLAXIS; PREVENTION; MANAGEMENT; PENICILLIN; INFECTION; REGIMENS;

D O I：

10.1097/IM9.0000000000000154

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Relapsing fever is an acute infectious disease caused by a variety of relapsing fever-associated spirochetes, for which no optimal treatment has been developed. The purposes of this study were to compare the efficacy and safety of commonly used antibiotics for the treatment of relapsing fever using a network meta-analysis approach and to explore the advantages of each drug based on the current evidence. This study examined nine published studies involving 1416 patients with relapsing fever treated with penicillin, erythromycin, tetracycline, doxycycline, minocycline or chloramphenicol. The odds ratio (OR) and 95% confidence interval (CI) were used as influence indices for discontinuous data, and the efficacy and safety of drugs were ranked by the surface under the cumulative ranking (SUCRA) curve. The primary outcomes of this study were mortality and cure rates, and the secondary outcomes were the rates of Jarisch-Herxheimer reaction and relapse. Erythromycin (SUCRA, 84.5%) was the most effective antibiotic for reducing mortality, whereas tetracycline was the most effective antibiotic for improving the cure rate (SUCRA, 69.3%) and reducing the relapse rate (SUCRA, 79.7%), and minocycline (SUCRA, 66.4%) was the most effective antibiotic for reducing Jarisch-Herxheimer reactions. In addition, our network meta-analysis showed that tetracycline is superior to penicillin for improving the cure rate (OR, 5.91; 95% CI, 2.21-15.81) and reducing the relapse rate (OR, 0.16; 95% CI, 0.04-0.67).

引用

页码：127 / 133

页数：7

共 25 条

[1] Post exposure prophylaxis of tick-borne relapsing fever [J].