{Reference Type}: Journal Article {Title}: Meta-analysis unravels the complex combined toxicity of microplastics and antibiotics in aquatic ecosystems. {Author}: Yu Z;An Q;Zhou T;Zhou L;Yan B; {Journal}: Sci Total Environ {Volume}: 929 {Issue}: 0 {Year}: 2024 Jun 15 {Factor}: 10.753 {DOI}: 10.1016/j.scitotenv.2024.172503 {Abstract}: The aquatic ecosystem, a repository for various pollutants, has been identified as a crucial zone where microplastics (MPs) serve as vectors for antibiotics, facilitating their spread. Despite this, the influence of MPs on the toxicity of antibiotics remains a topic of debate. In this study, we conduct a global meta-analysis, examining 730 datasets from 29 laboratory studies. Our findings reveal that the impact of MPs on antibiotic toxicity is highly dependent on biological response pathways, microplastic concentration, antibiotic properties, and exposure time. We observed that MPs amplify the accumulation of antibiotics in aquatic organisms, significantly heightening their adverse effects on growth, development, and immune functions. Intriguingly, MPs appear to mitigate the reproductive toxicity caused by antibiotics. A notable inverse relationship was identified between antibiotic toxicity and microplastic concentration and exposure time. Furthermore, antibiotic concentration predominantly affects growth, development, and reproductive health, whereas exposure time is critical in determining antibiotic accumulation and immune-related toxicity. These insights underscore that microplastic co-exposure can modify the toxicological profile of antibiotics. The outcomes of this research enhance our comprehensive understanding of the intricate combined effects of MPs and antibiotics on aquatic life, emphasizing the necessity for informed scientific management of these emerging contaminants.