The effectiveness of various treatment regimens of urogenital Chlamydia trachomatis infections: A systematic review with meta-analysis

Introduction. In Russia, chlamydia infection consistently ranks second in the ranking of sexually transmitted diseases, with an incidence of 17.8 cases per 100,000 population. The presence of associations between C. trachomatis and resistant strains of opportunistic pathogens can lead to the development of polymicrobial bacterial biofilms, contributing to the chronic course of the infection and its resistance to treatment. Given the social significance of chlamydia infection and the frequent presence of polymicrobial bacterial co-infections, research is being conducted to evaluate the effectiveness of additional antimicrobial therapy.
Aim. To evaluate the effectiveness of Wobenzym in the complex treatment of urogenital chlamydia infection, including the frequency of pathogen eradication and changes in the immune status.
Materials and methods. The meta-analysis included randomized and non-randomized controlled studies on the effectiveness of Wobenzym in the complex treatment of urogenital chlamydia infection and antibiotic therapy. The systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, Version 6.4, 2023. The risk of bias was assessed using the ROBINS-I tool.
Results and discussion. A literature search using keywords yielded 616 publications, 7 publications were selected for inclusion in the analysis for the period from 1996 to 2023. It has been established that the inclusion of Wobenzym in complex therapy increases the likelihood of pathogen eradication (OR 8.33; 95% CI 2.98–23.30), the likelihood of achieving clinical recovery (OR 4.72; 95% CI 1.85–12.06), and has a positive effect on immune status indicators, including phagocytosis, content of circulating immune complexes, interferon status, pro-inflammatory cytokines, and the readiness for apoptosis and lymphocyte activation. However, the low percentage of pathogen eradication after antibiotic therapy (22.2–32.5%), presented in a number of studies, is controversial.
Conclusion. The conducted meta-analysis demonstrated the effectiveness of complex therapy with the inclusion of Wobenzym in urogenital chlamydia infection. However, the questionable results of a number of studies require further study of this issue and additional comparative studies of the effectiveness of complex therapy.

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