A Cochrane review included 11 trials involving a total of 7 535 women. There were no significant differences in clinical or microbiological efficacy between quinolones. Photosensitivity reactions were more frequently observed for sparfloxacin when compared to ofloxacin. Any adverse event, adverse events causing withdrawal, skin adverse events, and photosensitivity reactions were more common for lomefloxacin when compared to norfloxacin. Any adverse event, adverse drug reactions, and CNS adverse events were more common for ofloxacin when compared to ciprofloxacin. CNS adverse events and insomnia were more often reported for rufloxacin when compared to pefloxacin. Adverse drug reactions occurred frequently for ofloxacin than levofloxacin. Insomnia was reported more frequently for enoxacin than ciprofloxacin.
Another Cochrane review included 21 studies with a total of 6016 subjects comparing different antimicrobial treatments (7 days) for acute uncomplicated lower UTI. Short-term cure was defined as absence of urinary symptoms up to 2 weeks after start of treatment or negative urine culture within 2 weeks, and long-term follow-up was up to 8 weeks. For symptomatic cure, no difference was found between different antimicrobial treatments (trimethoprim-sulfamethoxazole (TMP-SMX), fluoroquinolones, beta-lactam drugs, and nitrofurantoin. For bacteriological cure, fluoroquinolones were more effective than beta-lactams in short-term, but not more effective than TMP-SMX. Minimal data were available on resistant strains during or after antimicrobial treatment.