{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:04:27Z","timestamp":1785546267029,"version":"3.56.0"},"reference-count":77,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T00:00:00Z","timestamp":1630281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"NHMRC Senior Research Fellowship","award":["GNT1042907"],"award-info":[{"award-number":["GNT1042907"]}]},{"name":"NHMRC Senior Research Fellowship","award":["APP1181057"],"award-info":[{"award-number":["APP1181057"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rectal gonorrhoea is a common sexually transmitted infection with increasing antimicrobial resistance requiring optimization of available treatments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This systematic review aimed to assess the efficacy of current treatments, previously trialled treatments and new emerging treatments for rectal Neisseria gonorrhoeae (NG).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Online bibliographic databases were search from 1 January 1946 to 14 August 2020. All randomized controlled trials (RCTs) with rectal NG data among participants aged 15\u2009years or above and published in English were included. Random effects meta-analyses were used to estimate overall treatment efficacy, defined as microbiological cure. Sub-group analyses included stratifying by diagnostic assay, by dual versus monotherapy, and by currently recommended treatments (e.g. ceftriaxone \u00b1 azithromycin) versus previously trialled but not recommended treatments (e.g. amoxicillin) versus emerging treatments (e.g. zoliflodacin). The study protocol was registered on PROSPERO (CRD42020202998).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>54 studies including 1813 participants and 44 treatment regimens were identified. The overall summary treatment efficacy for rectal NG was 100.0% (95% CI: 99.9%\u2013100.0%; I2\u200a=\u200a0.0%; P\u200a=\u200a0.86). Efficacy estimates for monotherapies (100.0%; 95% CI: 99.88%\u2013100.0%; I2\u200a=\u200a0.00%; P\u200a=\u200a0.97) and dual therapies (100.0%; 95% CI: 97.65%\u2013100.0%; I2\u200a=\u200a56.24%; P\u200a=\u200a0.03) were similar. Efficacy was highest for current treatments (100.00%; 95% CI: 99.96%\u2013100.00%; I2\u200a=\u200a0.00%; P\u200a=\u200a0.98) versus emerging treatments (97.16%; 95% CI: 86.79%\u2013100.00%; I2\u200a=\u200a0.00%; P\u200a=\u200a0.84). There were no trials exclusively investigating rectal NG and small sample size was a limitation in most trials.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Currently recommended treatments containing ceftriaxone, as mono or dual therapy, are effective. Emerging drugs such as zoliflodacin may be potentially useful for rectal NG but further data are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkab315","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T19:11:34Z","timestamp":1628622694000},"page":"3111-3124","source":"Crossref","is-referenced-by-count":13,"title":["Treatment efficacy for rectal <i>Neisseria gonorrhoeae<\/i>: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1093","volume":"76","author":[{"given":"Fiona Wing Yu","family":"Lo","sequence":"first","affiliation":[{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian Yuh Shiong","family":"Kong","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S","family":"Hocking","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,30]]},"reference":[{"key":"2021111722580162900_dkab315-B1","doi-asserted-by":"crossref","first-page":"548","DOI":"10.2471\/BLT.18.228486","article-title":"Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016","volume":"97","author":"Rowley","year":"2019","journal-title":"Bull World Health Organ"},{"key":"2021111722580162900_dkab315-B2","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1136\/sextrans-2018-053950","article-title":"Factors associated with anorectal Chlamydia trachomatis or 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