Sixteen RCTs (n=6,584) were included: 12 RCTs (n=4,851) compared orally-administered new FQs with orally-administered comparator antibiotics; 3 RCTs (n=1,316) compared IV or IV/oral FQ therapy with IV or IV/oral comparator antibiotics; and one RCT (n=417) compared an IV/oral FQ to another IV/oral FQ.
There was one study of high quality, 9 of moderate quality and 6 of low quality; 3 studies of IV/oral treatment were of low quality and one was of moderate quality.
Orally administered FQs versus other antibiotics, intention-to-treat analyses (8 RCTs): no statistically-significant difference in clinical success was found (RD 1.7%, 95% CI: -1.4, 4.8).
Orally administered FQs versus other antibiotics, all studies (12 RCTs): new FQs were slightly more successful (RD 2.9%, 95% CI: 0.5, 5.3).
IV/orally administered FQs versus other antibiotics, all studies (3 RCTs): new FQs were more successful (RD 5.4%, 95% CI: 2.1, 8.6).
Orally administered FQs that are approved for use in Canada (gatifloxacin and moxifloxacin) versus other antibiotics, (4 RCTs): no significant risk difference (RD -0.2%, 95% CI: -4.8, 4.5).
Orally administered trovafloxacin versus other antibiotics (5 RCTs): no significant risk difference (RD 2.2%, 95% CI: -0.7, 5.1).
IV/orally administered gatifloxacin versus levofloxacin (1 RCT): no significant risk difference (RD 1.4%, 95% CI: -3.3, 6.1).
Adverse events, orally administered FQs versus comparator antibiotics, intention-to treat analysis (7 RCTs): no difference in adverse event rates was found. The rate difference was 35.0% (95% CI: 21.2, 48.8) for FQs and 36.6% (95% CI: 23.4, 49.8) for comparator antibiotics.