Emerging Infectious Diseases (Oct 2016)

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

  • Charussri Leeyaphan,
  • Jason J. Ong,
  • Eric P.F. Chow,
  • Fabian Y.S. Kong,
  • Jane S. Hocking,
  • Melanie Bissessor,
  • Christopher K. Fairley,
  • Marcus Y. Chen

DOI
https://doi.org/10.3201/eid2210.160986
Journal volume & issue
Vol. 22, no. 10
pp. 1778 – 1784

Abstract

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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%, I2 = 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.

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