Moxifloxacin monotherapy for treatment of uncomplicated pelvic inflammatory disease: A systematic review and meta‐analysis with trial sequential analysis of randomized controlled trials

摘要

Abstract Purpose The aim of this study was to evaluate the efficacy and safety of moxifloxacin monotherapy for the treatment of uncomplicated pelvic inflammatory disease (uPID). Methods The literatures from PubMed, ScienceDirect, Google Scholar, Cochrane library and the http://clinicaltrials.gov/ were retrieved until February 2023. Only randomized controlled trials (RCTs) comparing the efficacy and safety of moxifloxacin with other antibiotics for treating uPID were included. The primary outcomes were clinical cure rate (CCR), bacteriological success rates (BSR) and risk of drug‐related adverse events (AEs). We used random‐effects modelled meta‐analysis, trial sequential analysis, and the Grading of Recommendations Assessment, Development, and Evaluation. This study was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42023428751). Results A total of four RCTs that enrolled 3201 women patients with uPID were included. In the per‐protocol populations, no significant difference was observed between patients given moxifloxacin and those given other antibiotics with regard to CCR at test‐of‐cure (TOC) (2485 patients, odds ratio OR?=?0.84, 95 confidence interval CI 0.68–1.04, p?=?0.12). Similarly, there was no statistically significant difference between patients given moxifloxacin and those given other antibiotics in terms of BSR at TOC (471 patients, OR?=?1.17, 95 CI 0.70–1.96, p?=?0.56) in the microbiologically valid population. However, drug‐related AEs occurred less frequently with moxifloxacin than with other antibiotics (2973 patients, OR?=?0.74, 95 CI 0.64–0.86, p?