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OBJECTIVE: To systematically review the efficacy and safety of cefoperazone and sulbactam in the treatment of lower respiratory infection. METHODS: Randomized controlled trials on cefoperazone and sulbactam in the treatment of lower respiratory infection (the intervention group was given cefoperazone and sulbactam, no limits for dosage and courses; the control group was given other antibiotics, such as piperacillin tazobactam, ceftazidime, levofloxacin and moxifloxacin, also no limits for dosage and courses) were retrieved from the Cochrane Library, PubMed, Embase, CNKI and Wanfang Data, and the search date was up to Jun. 2021. After literature screening and data extracting, the literature quality was evaluated using the assessment tool of risk bias recommended in the Cochrane Systematic Assessor' s Handbook 5.1, and Meta-analysis was performed using RevMan 5. 3 software. RESULTS : Totally 16 studies were finally enrolled, including 1347 patients. Results of Meta-analysis indicated that the difference in clinical effective rate between intervention group and control group had no statistical significance ( OR = 1.18, 95%CI= 0. 87-1. 61,P>O. 05); in the subgroup analysis with piperacillin tazobactam as a control, the difference in clinical efficiency between intervention group and control group still had no statistical significance ( OR = 0. 80, 95%CI=O. 39-1. 65,P>O. 05 ) . The difference in bacterial clearance rate between intervention group and control group had no statistical significance (OR= l.13, 95% CI= 0. 76-1. 68, P> 0. 05) ; in the subgroup analysis with piperacillin tazobactam as control, the difference in bacterial clearance rate between intervention group and control group still had no statistical significance (OR= 0. 76, 95% CI= 0. 31-1. 91, P> 0. 05) ; There was no statistically significant difference in the incidence of adverse drug reactions between intervention group and control group ( OR= 0. 97, 95% CI= 0. 58- 1. 62,P>O. 05). CONCLUSIONS: The cefoperazone and sulbactam has similar clinical efficacy and safety with control drugs in the treatment of lower respiratory infection. [ABSTRACT FROM AUTHOR]