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The majority of included studies were retrospective (95%, 19\/20) and had moderate risks of bias (80.0%, 16\/20). The results indicated VAN+PTZ was associated with a significantly higher risk of AKI compared with VAN plus other BLs (OR = 1.66, 95% CI = 1.42-1.94,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). Subgroup analyses showed that compared with adults, children were associated with a higher risk of AKI when receiving VAN+PTZ (OR = 3.16 vs 1.59). Also, VAN+PTZ was associated with a significantly higher risk of severe stage 2 to 3 AKI than VAN plus other BLs (OR = 1.63, 95% CI = 1.28-2.06,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). No significant difference was identified in mortality, dialysis, time to AKI, and length of stay between patients receiving VAN plus PTZ and other combinations.\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : In critically ill, VAN plus PTZ was associated with an increased risk of AKI and severe stage 2 to 3 AKI compared with VAN plus other BLs, especially in children. However, more high-quality multicenter, prospective cohort studies, and randomized controlled studies are needed.\n                  <\/jats:p>","DOI":"10.1177\/87551225251350894","type":"journal-article","created":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T05:38:12Z","timestamp":1753594692000},"page":"291-302","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence of Acute Kidney Injury in Critically Ill Patients Receiving Vancomycin With Concomitant Piperacillin-Tazobactam Versus Other Beta-Lactams: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"41","author":[{"given":"Ranyi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pharmacy, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenqi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xialian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiang","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Nephrology, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0866-1546","authenticated-orcid":false,"given":"Qianzhou","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, ZhongShan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3907-2939","authenticated-orcid":false,"given":"Kunming","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, ZhongShan Hospital, Fudan University, Shanghai, China"},{"name":"Department of Pharmacy, ZhongShan Hospital, Fudan University (Xiamen Branch), Xiamen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa570"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.05.009"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.03.019"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.03.046"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-022-06861-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.20583"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-022-06811-0"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxlet.2018.06.1220"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2017.12.037"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00013.2012"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-019-00846-x"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"e_1_3_2_14_2","unstructured":"Wells GA Shea B O\u2019Connell D et al. 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