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

Systematic Review and Meta-Analysis of Doxycycline Efficacy for Rectal Lymphogranuloma Venereum in Men Who Have Sex with Men.
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Leeyaphan C, Ong JJ, Chow EP, Kong FY, Hocking JS, Bissessor M, Fairley CK, Chen M,


Leeyaphan C, Ong JJ, Chow EP, Kong FY, Hocking JS, Bissessor M, Fairley CK, Chen M, (click to view)

Leeyaphan C, Ong JJ, Chow EP, Kong FY, Hocking JS, Bissessor M, Fairley CK, Chen M,

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Emerging infectious diseases 2016 Oct 1522(10) 1778-84 doi 10.3201/eid2210.160986

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.

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