<p>In recent years, the use of antibiotics in pediatric patients has received widespread. Tosufloxacin is a quinolone antimicrobial used to treat pneumonia, otitis media, cholera, and anthrax. Guidelines have recommended that quinolone antimicrobials can be used as alternatives for the treatment of bacterial infections in children. However, due to the potential adverse effects on bones and joints, the clinical application of fluoroquinolones requires further evaluation. This article reviewed the latest clinical evidence on the efficacy and safety of tosufloxacin for treating bacterial infections in children. Pharmacokinetic results suggested that drug clearance and volume of distribution were significantly correlated with body weight in children, and the higher the AUC and C_max, the higher the incidence of adverse drug effects. The efficacy results suggest that for Macrolide-resistant <i>Mycoplasma pneumoniae</i> (MRMP), tosufloxacin may have better efficacy compared to macrolide antibiotics, with minocycline being more efficacious than tosufloxacin. Tosufloxacin has good efficacy in the treatment of otitis media infections in children as well as children under 2 years of age, and it can be used as a second-line choice for children with persistent otitis media. The safety results suggest that the most important adverse effect of tosufloxacin is diarrhea, and there are almost no joint-related adverse effects. The rate of adverse effects of 6&#xa0;mg/kg tosufloxacin is higher than 4&#xa0;mg/kg group. Tosufloxacin may be safe and effective in children pneumonia and otitis media, but is less effective than minocycline in MRMP.</p>