title: Is the addition of aminoglycosides to beta-lactams in cancer patients with febrile neutropenia needed?
abstract: It is still controversial if the combined use of beta-lactam antibiotics and aminoglycosides has advantages over broad-spectrum beta-lactam monotherapy for the empirical treatment of cancer patients with febrile neutropenia. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including 14 pertinent randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded the combination of beta-lactam antibiotics and aminoglycosides probably does not lead to a reduced mortality in febrile neutropenic cancer patients and it might increase nephrotoxicity.
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Servicio de Medicina Interna, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile. Email: amherediac@gmail.com.
authors.forename: Valeria
authors.initials: V
authors.lastname: Contreras
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.
authors.forename: Sebastián
authors.initials: S
authors.lastname: Sepúlveda
authors.affiliation: Proyecto Epistemonikos, Santiago, Chile; Servicio de Medicina Interna, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile.
authors.forename: Ana
authors.initials: A
authors.lastname: Heredia
mesh_terms: D000617:Aminoglycosides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D064147:Febrile Neutropenia / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D047090:beta-Lactams / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D047090:beta-Lactams