Anti-MRSA quinolones for acute bacterial skin and skin structure infection: a systematic review and meta-analysis of randomized controlled trials

ABSTRACT

Objects

This study compared the clinical efficacy and safety of anti-methicillin-resistant Staphylococcus aureus (MRSA) quinolones for treating acute bacterial skin and skin structure infections (ABSSSIs).

Methods

PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant articles from inception to 21 July 2021. RCTs comparing the clinical efficacy and safety of anti-MRSA quinolones with other antibiotics for treating adult patients with ABSSSIs were included.

Results

Six RCTs were included. A total of 1,264 and 1,307 participants received the anti-MRSA quinolone-based study group and the control group. In the study group receiving anti-MRSA quinolone-based treatment, 935, 246, and 83 patients received delafloxacin, levonadifloxacin, and acorafloxacin, respectively. No significant difference was observed in the clinical cure rate at test of cure between the study and control groups (OR, 1.08; 95% CI, 0.91–1.29; I² = 0%). In patients with MRSA-associated ABSSSIs, the clinical cure rate (OR, 1.09; 95% CI, 0.71–1.65; I² = 0%) and microbiological response rate (OR, 1.24; 95% CI, 0.48–3.21; I² = 0%) of anti-MRSA quinolones were similar to those of other antibiotics.

Conclusions

The efficacy of anti-MRSA quinolone-based treatment is comparable to that of other anti-MRSA antibiotics for treating ABSSSIs.

KEYWORDS:

• Acute bacterial skin and skin structure infection
• delafloxacin
• levonadifloxacin
• acorafloxacin
• jnj-q2
• methicillin-resistantstaphylococcus aureus

Author contribution

Conception: CMC, CCL, and WTL

Study design: CMC, TSW and CCL

Analysis and interpretation: TSW, YHC and CCL

Drafted or written: CMC and CCL

Substantially revised or critically review: WTL

All authors have agreed on the journal to which the article will be submitted and reviewed and agreed on all versions of the article before submission, during revision, the final version accepted for publication, and any significant changes introduced at the proofing stage. In addition, all authors agree to take responsibility and be accountable for the contents of the article and to share responsibility to resolve any questions raised about the accuracy or integrity of the published work.

Additional information

Funding

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.