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Bibliographic details: Zou J, Dong J, Yu XF.  Meta-analysis of the efficacy of levofloxacin-based triple regimen and quadruple rescue regimen therapy for eradication of Helicobacter pylori. World Chinese Journal of Digestology 2009; 17(11): 1160-1165

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Bibliographic details: Wang XH, Liu XJ.  Moxifloxacin versus levofloxacin for acute exacerbation of chronic obstructive pulmonary diseases: a systematic review. Chinese Journal of Evidence-Based Medicine 2012; 12(6): 694-699 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=201206014

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis bacteria. Over two billion people worldwide are believed to be latently infected with TB and approximately 10% of these people will develop active TB later in life. The World Health Organization currently only recommend treatment with fluoroquinolones for patients who cannot take standard first‐line drugs. In this review, we examined the effect of including fluoroquinolones in first‐line treatment regimens on people with presumed drug‐sensitive tuberculosis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Urinary tract infection (UTI) refers to the presence of a certain threshold number of bacteria in the urine. Bacterial cystitis (bacteria in the bladder, also called acute cystitis) can occur in men and women and the signs and symptoms include dysuria (pain on passing urine), frequency, cloudy urine, occasionally haematuria (blood in the urine), and is often associated with pyuria (high urine white blood cell count). There is an additional important distinction between complicated and uncomplicated UTI. Complicated UTIs are those associated with fever and/or back pain (indicating kidney infection), UTIs in men, UTIs associated with indwelling or intermittent urinary catheters, obstructive uropathy (any changes in the urinary tract due to obstruction), vesicoureteric reflux (urine travels from the bladder back up toward the kidneys) and other urological abnormalities. These types of infections require more intensive treatment. Uncomplicated acute cystitis is the most prevalent form of uncomplicated UTI in women. Quinolones are recommended as the drugs of choice for acute cystitis in regions where the level of resistance to other antimicrobials namely co‐trimoxazole is high. The aim of this systematic review was to investigate which quinolone is most effective in treating uncomplicated acute cystitis and to also investigate safety and how well they are tolerated. Eleven studies (7535 women) were identified. No two studies compared the same quinolones. We found no significant differences in clinical or microbiological efficacy between quinolones. Several adverse events were reported in the individual studies. These included photosensitivity, insomnia, skin adverse events, central nervous system adverse events and adverse events leading to withdrawal to treatment. We were unable to determine which quinolone would be the safest or the most tolerated due to the lack of head‐to‐head data.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Bibliographic details: Zhu H, Lei X, Zhang F, Zhang ZJ, Lu J, Li H, Wang Y.  Effectiveness and safety of levofloxacin for multidrug resistant pulmonary tuberculosis: a systematic review. Chinese Journal of Evidence-Based Medicine 2012; 12(2): 201-208 Available from: http://www.cjebm.org.cn/en/oa/DArticle.aspx?type=view&id=201202013

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Levofloxacin is a widely used fluoroquinolone approved for the treatment of complicated urinary tract infections and acute pyelonephritis. A comprehensive review of the medical literature identified five publications evaluating levofloxacin for the treatment of either complicated urinary tract infections or acute pyelonephritis. All trials, although variable in their inclusion criteria and levofloxacin dosing strategies, reported microbiologic, clinical, and safety-related outcomes. High microbiologic eradication rates, ranging from 79.8% to 95.3%, were observed in all studies. Escherichia coli was the most commonly isolated uropathogen. Data on levofloxacin resistance, both at baseline and after therapy, were limited. Clinical success was observed to range from 82.6% to 93% when measured after the completion of therapy. These clinical and microbiologic results were comparable to the fluoroquinolone comparators in all trials. Insufficient data are available to evaluate the outcomes in any meaningful patient subgroups, including catheterized patients, and those with other specific complicating factors. Levofloxacin was well tolerated in these studies, with headache, gastrointenstinal effects, and dizziness being the most commonly reported adverse events. The published data support the use of levofloxacin in complicated urinary tract infections and acute pyelonephritis. Further trials are necessary to evaluate levofloxacin within specific patient sub-populations.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

OBJECTIVE: To evaluate the effectiveness and safety of the proton pump inhibitor and levofloxacin based first-line triple therapy in the eradication of Helicobacter pylori (Hp).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Brucellosis is a common infection caused by Brucella bacteria species and can infect both people and animals. It is spread by eating infected food products and through direct contact with infected animals. The bacterial infection can affect different tissues and organs and is treated using antibiotics. Current recommended treatment regimens involve the use of two or more antibiotics in order to avoid relapses occurring and to prevent prolonged use of these drugs, which may lead to problems of drug resistance arising. Drug resistance is a particularly important issue as most people infected with brucellosis live in low socioeconomic areas of developing countries, where tuberculosis is also an endemic health problem. Thus there are concerns over the potential increase in resistance to tuberculosis drugs due to their prolonged use in treating brucellosis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

This review concluded that a 10-day course of levofloxacin-based triple therapy is more effective and better tolerated than a 7- day course of bismuth-based quadruple salvage therapy for the treatment of persistent Helicobacter pylori infection. However, it is unclear how reliable the conclusions are, given the reliance on a small number of variable studies and the lack of a validity assessment.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

The review concluded that second-generation fluoroquinolone-based triple therapy (moxifloxacin and levofloxacin), especially 10-day levofloxacin-based triple therapy, was the regimen of choice for rescue therapy eradication of persistent Helicobacter pylori infection. These conclusions reflect the evidence base, but potential bias in the review process and unknown quality of the included studies mean they should be considered tentative.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

BACKGROUND: Standard triple therapy for Helicobacter pylori infection fails in up to one quarter of patients. Levofloxacin-based triple therapy may be more efficacious.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

BACKGROUND: First-line levofloxacin-based treatments eradicate Helicobacter pylori with varying success. We examined the efficacy and safety of first-line levofloxacin-based treatment in comparison to standard first-line therapy for H pylori eradication.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

OBJECTIVES: To evaluate the available data on the efficacy and safety of levofloxacin-based triple therapy compared with standard triple therapy in first-line treatment for Helicobacter pylori infection.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

OBJECTIVES: Multidrug-resistant tuberculosis has emerged as a global health threat. Given poor treatment outcomes of fluoroquinolone-resistant multidrug-resistant tuberculosis, there is a pressing need for rapid drug susceptibility testing of multidrug-resistant Mycobacterium tuberculosis against fluoroquinolones. This review aims at evaluating these rapid assays.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

This review evaluated a potential increased anticoagulant response during concomitant therapy of warfarin and three commonly prescribed fluoroquinolones. Due to inconsistent findings, the authors concluded that there was insufficient evidence to support a potential increased anticoagulant response. The authors' conclusions were appropriate, but should be considered in the context of the review's methodological weaknesses.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

This review compared quinolones with other treatments for nosocomial (hospital-acquired) pneumonia. The authors concluded that quinolones may be as effective as comparator antibiotics in terms of clinical cure and mortality, but more effective in achieving microbiological eradication and preventing the development of resistance. This was a well-conducted review and the authors' conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Guidelines are recommendations for the care of individuals in specific clinical conditions or circumstances - and these can include prevention and self-care through to primary and secondary care and on to more specialised services. NICE clinical guidelines are based on the best available evidence of clinical and cost effectiveness, and are produced to help healthcare professionals and patients make informed choices about appropriate healthcare. While guidelines assist the practice of healthcare professionals, they do not replace their knowledge and skills.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: September 2012

The objectives of the study were to determine the effectiveness and incidence of adverse events of ofloxacin otic solution for suppurative otitis media compared with other treatments. All randomized controlled trials and nonrandomized comparative clinical trials published from 1966 to 2000 using ofloxacin otic solution as one of the interventions were reviewed and data were extracted and analyzed. Eleven clinical trials (9 randomized and 2 nonrandomized) enrolling 1,484 adults and children were finally included in the analysis. Five studies employed clear concealment procedure in the allocation of treatment whereas evaluation of outcome was at least single-blinded in 6 trials. The probability of overall cure rate was higher with 0.3% ofloxacin otic solution than with other topical or systemic antibiotics in 9 of the studies analyzed (OR = 2.67; 95% CI = 2.04, 3.50). Resolution of secondary outcome parameters evaluated at least 1 week after treatment was higher with 0.3% ofloxacin otic solution: resolution of otalgia (4 trials; OR = 2.41; 95% CI = 1.2, 4.82); resolution of otorrhea (11 trials; OR = 2.78; 95% CI = 2.12, 3.65), and bacterial eradication rate (6 trials; OR = 3.86; 95% CI = 2.54, 5.87). A subgroup analysis of 4 studies comparing ofloxacin otic solution with antibiotic- and steroid-containing otic solution showed a higher cure rate for ofloxacin otic solution (OR = 2.73; 95% CI = 1.52, 4.90). Another subgroup analysis on 3 studies comparing ofloxacin otic solution with oral systemic antibiotics showed higher resolution of otorrhea with ofloxacin otic solution (OR = 2.78; 95% CI = 2.12, 3.65). Of 4 studies with data on adverse events, the probability of adverse events was lower with ofloxacin otic solution than with other topical antibiotics (OR = 0.28; 95% CI = 0.19, 0.42). Subgroup analysis showed that 0.3% ofloxacin otic solution showed better results in terms of overall cure rate, resolution of otorrhea, otalgia, bacterial eradication rate and incidence of adverse events. Whether due to chronic suppurative otitis media (CSOM) or draining tympanostomy tube, the overall cure rate (CSOM OR = 4.86; with tympanostomy tube OR = 2.13) and resolution of otorrhea (CSOM OR = 4.42; with tympanostomy tube OR = 1.66) were likewise in favor of 0.3% ofloxacin otic solution. The studies included in this meta-analysis showed generally homogenous results in all clinical and laboratory outcomes analyzed, except for the evaluation of adverse events. The authors conclude that 0.3% ofloxacin otic solution is better than other otic antibiotic drops and other oral antibiotics in terms of overall cure rate and resolution of secondary outcome parameters. Estimates on the beneficial effects of ofloxacin otic solution are limited to the period of study included in this review.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Bibliographic details: Zhang F, Chen A J, Shi J.  Meta-analysis of the efficacies on gatifloxacin tablets versus levofoxacin tablets in the treatment of acute bacterial infections. Chinese Journal of Antibiotics 2007; 32(2): 113-116, 127

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

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