Abstract

Objective: T0 assess both the strength and boundaries of rabies post-exposure prophylaxis (PEP) treatments for exposed risk groups.
Methodology: The search followed PRISMA 2020 guidelines from 2010 to 2025 within PubMed and Scopus and Web of Science databases. Studies that fit the criteria included clinical trials, retrospective and prospective studies, cost-effectiveness analyses and case reports. Two reviewers independently extracted data. The risk of bias was assessed through the Evidence Project Risk of Bias Tool. A meta-analysis utilized random effects model to measure the effectiveness of pool of PEP against rabies prevention.
Results: The analysis evaluated 70 identified records, 10 studies fulfilling the inclusion criteria. The implementation of PEP procedures resulted in almost 100% success rates. Patients living in LMICs showed poor adherence to their treatment course because of financial constraints and logistic reasons. Immunocompromised patients exhibited weakened immune reactions to vaccinations thus requiring specific changes in dosage. The absence of rabies immune globulin (RIG) availability in rural areas revealed significant limitations for PEP effectiveness. Intradermal vaccination proved to be an economical option which helped patients follow recommended treatment properly.
Conclusion: Although rabies PEP demonstrates high efficacy, challenges such as non-adherence, RIG scarcity, and immune response variability among vulnerable populations limit its optimal impact. Policy interventions should prioritize the free of cost PEP programs, improved vaccine access and customized immunization strategies to enhance rabies prevention.

Key words: Rabies, post-exposure prophylaxis, immunization, treatment outcome.