我们对比较 β-内酰胺与 β-内酰胺加氨基糖苷类治疗癌症患者发热性中性粒细胞减少症的研究进行了系统回顾。我们检索了 CENTRAL、MEDLINE 和 Embase，查找截至 2023 年 10 月发表的研究以及随机对照试验（纳入的随机对照试验 (RCT) 比较了抗铜绿假单胞菌 β-内酰胺单一疗法与抗铜绿假单胞菌 β-内酰胺和氨基糖苷类药物的任意组合。 联合疗法的全因死亡率与单一疗法相比没有显着差异 (RR 0.99，95% CI 0.84 至 1.16，证据质量高）。感染相关死亡率显示，与单一疗法干预相比，联合疗法具有较小的积极影响（RR 0.83，95% CI 0.66至1.05，证据质量高）。关于治疗失败，联合治疗与单药治疗相比没有显着差异（RR 0.99，95% CI 0.94至1.03，证据质量低）。在敏感性分析中，2010 年至 2019 年期间发布的治疗失败数据显示，同一 β-内酰胺组有更好的结果（RR 1.10 [95% CI，1.01-1.19]）。任何每日给药方案的联合治疗均更容易出现肾衰竭（RR 0.46，95% CI 0.36 至 0.60，证据质量高）。我们发现将氨基糖苷类药物与窄谱 β-内酰胺类药物联合使用时，不遗余力使用广谱药物。谱抗生素。很少有研究包括抗生素耐药细菌和氨基糖苷类血清水平的详细研究，并且联合使用相同的β-内酰胺的研究显示联合治疗的影响很小。未来，将需要进行包括抗生素耐药细菌概况和血清氨基糖苷类水平监测在内的研究。

We performed a systematic review of studies that compared beta-lactams vs. beta-lactams plus aminoglycosides for the treatment of febrile neutropenia in cancer patients.We searched CENTRAL, MEDLINE, and Embase for studies published up to October 2023, and randomized controlled trials (RCTs) that compared anti-Pseudomonas aeruginosa beta-lactam monotherapy with any combination of an anti-Pseudomonas aeruginosa beta-lactam and an aminoglycoside were included.The all-cause mortality rate of combination therapy showed no significant differences compared with that of monotherapy (RR 0.99, 95% CI 0.84 to 1.16, high certainty of evidence). Infection-related mortality rates showed that combination therapy had a small positive impact compared with the intervention with monotherapy (RR 0.83, 95% CI 0.66 to 1.05, high certainty of evidence). Regarding treatment failure, combination therapy showed no significant differences compared with monotherapy (RR 0.99, 95% CI 0.94 to 1.03, low certainty of evidence). In the sensitivity analysis, the treatment failure data published between 2010 and 2019 showed better outcomes in the same beta-lactam group (RR 1.10 [95% CI, 1.01-1.19]). Renal failure was more frequent with combination therapy of any daily dosing regimen (RR 0.46, 95% CI 0.36 to 0.60, high certainty of evidence).We found combining aminoglycosides with a narrow-spectrum beta-lactam did not spare the use of broad-spectrum antibiotics. Few studies included antibiotic-resistant bacteria and a detailed investigation of aminoglycoside serum levels, and studies that combined the same beta-lactams showed only a minimal impact with the combination therapy. In the future, studies that include the profile of antibiotic-resistant bacteria and the monitoring of serum aminoglycoside levels will be required.