The efficacy and safety of nemonoxacin compared with levofloxacin in the treatment of community-acquired pneumonia: a systemic review and meta-analysis of randomized controlled trials

Shen-Peng Chang,1 Hong-Zin Lee,2 Chih-Cheng Lai,3 Hung-Jen Tang4 1Department of Pharmacy, Chi Mei Medical Center, Liouying, Taiwan; 2School of Pharmacy, China Medical University, Taichung, Taiwan; 3Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan; 4Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan Objectives: This meta-analysis aims to assess the clinical efficacy and safety of nemonoxacin in comparison with levofloxacin in treating community-acquired pneumonia (CAP).Materials and methods: The Pubmed, Embase, ClinicalTrials.gov., and the Cochrane databases were searched up to September 2018. Only randomized controlled trials (RCTs) evaluating nemonoxacin and levofloxacin in the treatment of CAP were included. The primary outcome was the clinical cure rate, and the secondary outcomes included the microbiologic response rate and the risk of adverse events.Results: Three RCTs were included. Overall, nemonoxacin and levofloxacin had similar clinical cure rates in the treatment of CAP (OR =1.05, 95% CI =0.67–1.64, I2=0%). Nemonoxacin also had a microbiologic response rate similar to levofloxacin (OR =0.89, 95% CI =0.44–1.81, I2=0%). No significant differences were found in treatment-emergent adverse events between the two drugs (OR =1.08, 95% CI =0.81–1.43, I2=0%). In subgroup analysis, the similarities in the clinical cure rate, microbiologic response rate, and risk of adverse events of these two drugs remained unchanged with the dose of nemonoxacin (500 or 750 mg) and individual pathogens.Conclusion: The clinical and microbiologic efficacy of nemonoxacin is comparable to that of levofloxacin in the treatment of CAP, and this agent is as well tolerated as levofloxacin. Keywords: nemonoxacin, levofloxacin, community-acquired pneumonia &nbsp