Insights into the fate and removal of antibiotics and antibiotic resistance genes using biological wastewater treatment technology

Abstract Antibiotics have become a critical concern worldwide due to the severe threats to human health and eco-environment. This review summarizes the fate of antibiotics and antibiotics resistance genes (ARGs) by biological treatment technologies and combined processes in wastewater treatment plants (WWTPs). Adsorption and biodegradation are the two major removal pathways for antibiotics. Adsorption is the main mechanism of antibiotics removal for Tetracyclines, Fluoroquinolones and Macrolides, while biodegradation is the pathway of antibiotics removal for Sulfonamides and β-Lactams. Additionally, the microbial co-metabolism process contributes to the biodegradation of antibiotics. In WWTPs, the antibiotics removal pathway and ARGs accumulation by different biological treatment technologies were provided. The ease of construction and set-up, simplicity of operation, flexibility in adapting to the fluctuations, capital and operating costs were discussed. Overall, the combined technologies should be further investigated as great application prospects in the treatment of antibiotics and alleviation of ARGs risk in the future.