Randomised controlled trials (RCTs) that compared fluoroquinolones with other conventional agents for the treatment of patients with osteomyelitis were eligible for inclusion in the review. Eligible trials also had to include a minimum of 10 patients in each treatment arm and report data on clinical success (the primary review outcome), bacteriological success, relapses, and super-infections and/or adverse events.
Among selected trials, fluoroquinolones included ofloxacin, ciprofloxacin, and pefloxacin. Comparators among the included trials all included beta-lactams (imipenem/cilastatin, ampicillin/sulbactam, amoxicillin/clavulanic, cefazoline or ceftazidime, broad spectrum cephalosporin or nafcillin-aminoglycoside, parental therapy with beta-lactams, or other appropriate antimicrobial therapy). Most trials were in patients with chronic osteomyelitis; some trials also included patients with acute osteomyelitis. The authors stated that most trials did not report details of the location of osteomyelitis or surgical procedures performed during the trial period.
Two reviewers independently selected studies for inclusion, with disagreements resolved by consensus among all review authors.