Fluoroquinolones versus β-lactam based regimens for the treatment of osteomyelitis: A meta-analysis of randomized controlled trials

Karamanis, EM; Matthaiou, DK; Moraitis, LI; Falagas, ME

dc.contributor.author	Karamanis, EM	en
dc.contributor.author	Matthaiou, DK	en
dc.contributor.author	Moraitis, LI	en
dc.contributor.author	Falagas, ME	en
dc.date.accessioned	2014-03-01T01:57:08Z
dc.date.available	2014-03-01T01:57:08Z
dc.date.issued	2008	en
dc.identifier.issn	03622436	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/28358
dc.subject	Ciprofloxacin	en
dc.subject	Diabetic foot	en
dc.subject	Imipenem	en
dc.subject	Ofloxacin	en
dc.subject	Pefloxacin	en
dc.subject.other	amikacin	en
dc.subject.other	aminopenicillin	en
dc.subject.other	amoxicillin plus clavulanic acid	en
dc.subject.other	antiinfective agent	en
dc.subject.other	beta lactam	en
dc.subject.other	cefazolin	en
dc.subject.other	ceftazidime	en
dc.subject.other	cilastatin	en
dc.subject.other	ciprofloxacin	en
dc.subject.other	clindamycin	en
dc.subject.other	cloxacillin	en
dc.subject.other	gentamicin	en
dc.subject.other	imipenem	en
dc.subject.other	metronidazole	en
dc.subject.other	ofloxacin	en
dc.subject.other	pefloxacin	en
dc.subject.other	quinoline derived antiinfective agent	en
dc.subject.other	sulfamethoxazole	en
dc.subject.other	sultamicillin	en
dc.subject.other	article	en
dc.subject.other	bacterial infection	en
dc.subject.other	bacterium isolate	en
dc.subject.other	clinical trial	en
dc.subject.other	combination chemotherapy	en
dc.subject.other	controlled clinical trial	en
dc.subject.other	controlled study	en
dc.subject.other	follow up	en
dc.subject.other	human	en
dc.subject.other	meta analysis	en
dc.subject.other	multicenter study	en
dc.subject.other	osteomyelitis	en
dc.subject.other	priority journal	en
dc.subject.other	Pseudomonas aeruginosa	en
dc.subject.other	randomized controlled trial	en
dc.subject.other	relapse	en
dc.subject.other	Staphylococcus aureus	en
dc.subject.other	superinfection	en
dc.subject.other	systematic review	en
dc.subject.other	treatment duration	en
dc.subject.other	treatment outcome	en
dc.subject.other	Anti-Bacterial Agents	en
dc.subject.other	beta-Lactams	en
dc.subject.other	Fluoroquinolones	en
dc.subject.other	Humans	en
dc.subject.other	Odds Ratio	en
dc.subject.other	Osteomyelitis	en
dc.subject.other	Randomized Controlled Trials as Topic	en
dc.subject.other	Recurrence	en
dc.subject.other	Risk Assessment	en
dc.subject.other	Superinfection	en
dc.subject.other	Treatment Outcome	en
dc.title	Fluoroquinolones versus β-lactam based regimens for the treatment of osteomyelitis: A meta-analysis of randomized controlled trials	en
heal.type	journalArticle	en
heal.identifier.primary	10.1097/BRS.0b013e31816f6c22	en
heal.identifier.secondary	http://dx.doi.org/10.1097/BRS.0b013e31816f6c22	en
heal.publicationDate	2008	en
heal.abstract	STUDY DESIGN. A meta-analysis of randomized control trials. OBJECTIVE. To compare fluoroquinolones to β-lactams for the treatment of osteomyelitis. SUMMARY OF BACKGROUND DATA. Treatment of osteomyelitis remains a real challenge in medicine necessitating the use of broad-spectrum antibiotics, because of the variety of the pathogens causing the infection and the fact that the infected bone may become necrotic and avascular, preventing systemic antibiotics from adequately penetrating to the infection site. METHODS. A literature search was performed by 2 reviewers independently (PubMed database and the Cochrane Central Register of Controlled Trials). RESULTS. We identified 7 studies eligible for inclusion in our meta-analysis; ciprofloxacin, ofloxacin, and pefloxacin were used in 3, 3, and 1 study, respectively, while various β-lactams (mainly in the intravenous form) were used as comparators. There was no difference in treatment success for osteomyelitis between fluoroquinolones and β-lactams [194 patients, fixed effect model (FEM), odds ratio (OR) = 0.99, 95% confidence interval (CI) 0.51-1.91], bacteriological success (201 isolates, FEM, OR = 0.88, 95% CI = 0.45-1.70), superinfections (173 patients, FEM, OR = 1.75, 95% CI = 0.63-4.90), relapses (153 patients, FEM, OR = 1.23, 95% CI = 0.46-3.31), or adverse events (170 patients, FEM, OR = 0.47, 95% CI = 0.21-1.06). CONCLUSION. Fluoroquinolones are as effective as β-lactams for the treatment of osteomyelitis and can be considered as a useful alternative in the physician's armamentarium. The value of fluoroquinolones for the treatment of osteomyelitis lies in the fact that they can be administered in an outpatient setting. However, they should be used with caution, so as to preserve their activity against increasingly resistant bacteria. © 2008 Lippincott Williams & Wilkins, Inc.	en
heal.journalName	Spine	en
dc.identifier.doi	10.1097/BRS.0b013e31816f6c22	en
dc.identifier.volume	33	en
dc.identifier.issue	10	en
dc.identifier.spage	E297	en
dc.identifier.epage	E304	en