Studies of any design in human subjects following prescription of fluoroquinolones (ciprofloxacin, levofloxacin and moxifloxacin) for active indications for a minimum of three days planned administration were eligible for inclusion. Studies needed to report either pro-thrombin time or international normalised ratio values. Only studies published in English were included.
Included patients had various comorbidities. Mean ages ranged from 48 years to 85 years; more than three-quarters of all patients were over 60 years of age. Almost all patients had documented stable anticoagulation parameters prior to receiving a fluoroquinolone. The use of ciprofloxacin was reported in 11 studies, levofloxacin in seven studies and moxifloxacin in three studies. One study reported the use of levofloxacin or gatifloxacin. Reported outcomes included mean international normalised ratio change, mean pro-thrombin time change (seconds), mean maximum pro-thrombin time (seconds), time to discovery of enhanced anticoagulation (days) and bleeding complications.
The authors stated neither how the papers were selected for the review nor how many reviewers performed the selection.