Objective To access the effectiveness and safety of levofloxacin in controlling multidrug resistant tuberculosis (MDR-TB). Methods The electronic searches in databases of PubMed, EMbase, The Cochrane Library, CNKI, CBM and VIP, handsearches and other searches were conducted from the date of their establishment to April 2011 for collecting randomized controlled trials (RCTs) on levofloxacin treating MDR-TB. Two researchers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, assessed the quality of the included studies by adopting the Jadad scale, and performed Meta-analysis by using RevMan 5.0 software. Results A total of 31 RCTs involving 2836 cases were included. The results of meta-analysis showed: a) Compared with the placebo group, levofloxacin could increase the sputum negative conversion rate after 3-month taking and at the end of the treatment period; b) Compared with the ofloxacin group, levofloxacin could increase the sputum negative conversion rate after 3 months and at the end of the treatment period; c) levofloxacin replacing either ethambutol or streptomycin could increase the sputum negative conversion rate after 3 months and at the end of the treatment period; d) Compared with the levofloxacin group, gatifloxacin and moxifloxacin could increase the sputum negative conversion rate after 3 months and at the end of the treatment period; e) There was no significant difference in the adverse reaction rate between each of the medication regimens (P=0.19). Conclusion Levofloxacin is more effective for MDR-TB than ofloxacin, ethambutol and streptomycin, but it is inferior to gatifloxacin or moxifloxacin. Its adverse reaction rate is equivalent to other medicines’.
Objective To assess the effectiveness and safety of moxifloxacin versus levofloxacin for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Such databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI and VIP were electronically searched, and the relevant conference proceedings were also hand-searched. The search time was up to July, 2011. Randomized controlled trials (RCTs) on moxifloxacin versus levofloxacin for AECOPD were included. Literature was screened according to inclusive and exclusive criteria, data were extracted, quality was assessed, and then meta-analysis was performed using RevMan 5.0. Results A total of 6 RCTs involving 482 patients with AECOPD were included. The results of meta-analysis showed that moxifloxacin group was significantly superior to levofloxacin group in the effective rate (OR=3.15, 95%CI 1.80 to 5.49, Plt;0.000 1). The bacterial clearance rate in moxifloxacin group was also higher than that in the levofloxacin group (OR=2.79, 95%CI 1.30 to 5.97, P=0.008). In addition, adverse effects of moxifloxacin group were less than levofloxacin (OR=0.48, 95%CI 0.24 to 0.98, P=0.04). Conclusion Based on current studies, moxifloxacin is superior to levofloxacin in improving effective rate and bacterial clearance rate, and in lowering side effects when treating AECOPD. Hence it is considerable to use moxifloxacin instead of levofloxacin in the treatment of AECOPD if necessary. Due to the limitation of both quantity and quality of included studies, this conclusion should be further confirmed with more high quality and large sample studies.
ObjectiveTo evaluate the effectiveness and side-effects of levofloxacin-based triple therapy as rescue regimen for Helicobacter pylori, and to compare it with the quadruple therapy. MethodsScience Direct, PubMed, Medline, China National Knowledge Infrastructure (CNKI), Chinese Social Sciences Citation Index (CSSCI, developed by Chongqing VIP Company), and Wanfang Database were electronically searched from January 2000 to September 2013. Randomized controlled trials (RCT) were focused on the eradication rate and adverse effects of levofloxacin-based regimens and generally recommended quadruple therapy after failure to eradicate Helicobacter pylori for one or more times. Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed using RevMan 5.0 software. ResultsFourteen literatures involving 1 402 patients were included. Meta-analysis showed that the levofloxacin-based group was better than the quadruple therapy group [RR=1.16, 95%CI (1.04, 1.30), P=0.009]. In addition, the adverse effects of levofloxacin group was less than the quadruple therapy group[OR=0.44, 95%CI (0.24, 0.81), P=0.008]. ConclusionAfter the failure of eradication of Helicobacter pylori, levofloxacin-based rescue regimen is more effective and better tolerated than the generally recommended quadruple therapy.