Abstract
This meta-analysis aimed to assess the efficacy and safety of sitafloxacin in treating acute bacterial infection. PubMed, Embase, and Cochrane databases were searched up to August 13, 2019. Only randomized controlled trials (RCTs) evaluating sitafloxacin and comparators in the treatment of acute bacterial infections were included. The outcomes were clinical and microbiological responses and the risk of adverse event (AE). Five RCTs were enrolled, including 375 and 381 patients who received sitafloxacin and the comparator, respectively. Overall, the clinical response rate of sitafloxacin in the treatment of acute bacterial infections was 94.6%, which was noninferior to that of the comparator (92.5%) (odds ratio (OR), 1.01; 95% CI, 0.24–4.32; I2 = 66%). For patients with complicated urinary tract infection (cUTI)/acute pyelonephritis (APN), the clinical response rate of sitafloxacin and the comparator was 96.9% and 91.3%, respectively (OR, 2.08; 95% CI, 0.35–12.44; I2 = 54%). For patients with pneumonia, the clinical response rate of sitafloxacin was 88.6%, which was comparable to that of the comparator (OR, 0.36; 95% CI, 0.11–1.21; I2 = 0%). The microbiological response of sitafloxacin was 82.0%, which was noninferior to that of the comparator (77.8%) (OR, 1.59; 95% CI, 0.77–3.28; I2 = 47%). The risk of treatment-emergent adverse event (TEAE), drug-related TEAE, and all-cause mortality were similar between sitafloxacin and the comparators (TEAE, OR, 1.14; 95% CI, 0.64–2.01, drug-related TEAE, OR, 1.14; 95% CI, 0.48–2.69, mortality, OR, 0.93; 95% CI, 0.09–9.44). In conclusion, sitafloxacin is noninferior to other commonly used antibiotics with respect to both clinical and microbiological response rates in patients with an acute bacterial infection, including cUTI/APN and pneumonia. In addition, sitafloxacin is also as safe as the comparators.
Highlights
Sitafloxacin is a new generation fluoroquinolone that exhibits excellent in vitro activity against many Gram-positive, Gram-negative, anaerobic bacteria, and atypical pathogens
Even for a multidrug resistant organism, such as the carbapenem-resistant Acinetobacter baumannii complex, sitafloxacin had a significantly lower minimum inhibitory concentration (MIC) in comparison with ciprofloxacin and levofloxacin, and the rate of resistance to sitafloxacin was significantly lower than that to ciprofloxacin and levofloxacin [4]. All these findings indicate that sitafloxacin has great activity against these commonly encountered pathogens in the clinical entity of respiratory tract infection and urinary tract infection and further suggests that sitafloxacin could be a promising antibiotic in the treatment of acute bacterial infection
Four studies [5,7,9,11] reported the risk of treatment‐emergent adverse event (TEAE), and we found found the risk of treatment-emergent adverse event (TEAE) was similar between sitafloxacin and the comparator
Summary
Sitafloxacin is a new generation fluoroquinolone that exhibits excellent in vitro activity against many Gram-positive, Gram-negative, anaerobic bacteria, and atypical pathogens. It remains active against the strains resistant to other fluoroquinolones [1]. Even for a multidrug resistant organism, such as the carbapenem-resistant Acinetobacter baumannii complex, sitafloxacin had a significantly lower MIC in comparison with ciprofloxacin and levofloxacin, and the rate of resistance to sitafloxacin was significantly lower than that to ciprofloxacin and levofloxacin [4] All these findings indicate that sitafloxacin has great activity against these commonly encountered pathogens in the clinical entity of respiratory tract infection and urinary tract infection and further suggests that sitafloxacin could be a promising antibiotic in the treatment of acute bacterial infection
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