ObjectiveTo systemically review the efficacy and safety of moxifloxacin for mycoplasma pneumoniae. MethodsSuch databases as PubMed, The Cochrane library (Issue 4, 2014), ISI, CBM, CNKI, VIP and WanFang Data were searched from inception to April 2014 for randomized controlled trials (RCTs) concerning moxifloxacin for mycoplasma pneumoniae. Two reviewers screened literature according to the inclusion and exclusion criteria, extract data, and assess methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 16 RCTs involving 1 401 patients were included. The results of meta-analysis showed that:compared with erythrocin or azithromycin, moxifloxacin had higher recovery rate (OR=2.35, 95%CI 1.76 to 3.15, P<0.000 01), higher bacterium negative rate (OR=3.74, 95%CI 1.76 to 7.96, P=0.000 6), and shorter fever clearance time (MD=-1.07, 95%CI -1.43 to -0.71, P<0.000 01); compared with azithromycin alone, moxifloxacin combined with azithromycin had higher recovery rate (OR=1.63, 95%CI 1.09 to 2.42, P=0.02), higher bacterium negative rate (OR=5.78, 95%CI 2.41 to 13.84, P<0.000 1), and shorter fever clearance time (MD=-0.99, 95%CI -1.52 to -0.47, P=0.000 2). In addition, there was a lower incidence of liver damage (OR=0.16, 95%CI 0.04 to 0.72, P=0.02) in patients who took moxifloxacin compared with erythromycin or azithromycin. No significant difference was found in the incidence of gastrointestinal adverse reaction between the two groups. ConclusionMoxifloxacin for mycoplasma pneumonia is more effective than macrolides (erythrocin or azithromycin) with a lower incidence of adverse reaction. Due to limited quantity and quality of the included studies, the above conclusion should be further verified by conducting more high quality, large scale, multicentre RCTs.