A critical review of antibiotic removal strategies: Performance and mechanisms

Environmental pollution by antibiotics has severely affected human health and development. Antibiotic resistance genes (ARGs) have also been recognized as emerging pollutants because of their persistence and adverse impacts in aquatic ecosystems, even at low concentrations. For the alleviation and elimination of antibiotics stress, several approaches have been proposed, some of which have been applied in practice. This review systematically summarizes the removal strategies for various antibiotics and their corresponding mechanisms, including chemical, physical, biological, condition-based and combined strategies. Moreover, a comparison among these methods is made with a focus on the performance and efficiency. Further research needs are also proposed, which provides a guidance for the establishment of a control strategy to achieve simultaneous removal of nitrogen, antibiotics and ARGs.