Clinical Efficacy and Safety Analysis of Levofloxacin for the Prevention of Infection After Traumatic Osteoarthrosis and Internal Fixation: Systematic Review and Meta-Analysis

Objective: Levofloxacin has been widely used in clinical anti-infection treatment; however, its adverse reactions to levofloxacin were also obvious in patients. Herein we aimed to systematically evaluate the clinical efficacy and safety of systemic administration of levofloxacin in the prevention of postoperative infection after traumatic osteoarthrosis and internal fixation.

Methods: PubMed, Cochrane Library, OVID, EBSCO, CNKI, VIP database, and Wanfang Database were searched from December 1993 to December 2021. Meanwhile, China ADR Information Bulletin and WHO Pharmaceutical were searched manually. Newsletter and FDA Drug Safety Newsletter, also to retrieve the Websites of Chinese, Chinese, and drug regulatory authorities; To obtain data on adverse events in children with systemic administration of levofloxacin. The literature was screened according to inclusion and exclusion criteria. The risk of bias was evaluated for the included RCT literature.

Results: There was a statistical difference in the comparison of the incidence of fever between the experimental group and the control group (OR = 2.29, 95% CI (1.75,2.98), < 0.00001, I = 0%,  = 6.11); elevated white blood cell count (OR = 1.82, 95% CI (1.31,2.52),=0.0003, I = 0%,  = 3.60); incidence of wound infection (OR = 2.11, 95% CI (1.54,2.90), < 0.00001, I = 0%,  = 4.64); adverse drug reaction (OR = 1.82, 95% CI (1.21,2.74),=0.004, I = 0%,  = 2.86).

Conclusion: In the clinical use of levofloxacin, adverse drug reactions including fever, elevated white blood cell count, and wound infection should be concerned.