Ozenoxacin 1% in Pediatric and Adult Patients with Impetigo: A Meta-Analysis of Randomized Trials

Introduction: Impetigo is a relatively common superficial infection of the skin and soft tissues. Although its prevalence is more significant in childhood, it might also occur in adulthood, affecting the quality of life of our patients. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ozenoxacin 1% with placebo or mupirocin was conducted. Databases searched included PubMed, Embase, Cochrane Library, and ClinicalTrials.gov. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using a random-effects model, and heterogeneity was assessed using I² statistics. Results: Four RCTs with 754 patients met the inclusion criteria. Ozenoxacin significantly improved the clinical success (RR: 1.14, 95% CI: 1.04-1.26, and I² = 0%) and reduced the clinical failure (RR: 0.54, 95% CI: 0.39-0.75, and I² = 0%) compared to the placebo. Microbiological success was also superior (RR: 1.31, 95% CI: 1.05-1.58, and I² = 4%), while the microbiological failure was significantly lower (RR: 0.31, 95% CI: 0.21-0.46, and I² = 0%). Comparisons with mupirocin showed similar efficacy, though the estimates were less precise. Conclusions: Ozenoxacin 1% is an effective treatment for impetigo, significantly improving clinical and microbiological outcomes while reducing the failure rates compared to the placebo. Its efficacy is comparable to mupirocin, suggesting it as a viable alternative for first-line therapy. Given the low heterogeneity observed, these findings support the clinical use of ozenoxacin for impetigo management. Future large-scale RCTs and direct comparative studies are warranted to further validate its therapeutic benefits.