Occurrence, fate, and ecological risk of antibiotics in wastewater treatment plants in China: A review

This review offers a comprehensive overview of the occurrence, fate, and ecological risk associated with six major categories of antibiotics found in influent, effluent, and sludge from urban wastewater treatment plants (WWTPs) in China. Further exploration includes examining the correlation between antibiotic residual rates in the effluents and process parameters of urban WWTPs across the country. Lastly, a nationwide and urban cluster-specific evaluation of the ecological risk posed by antibiotics in WWTPs is conducted. The findings reveal that the average concentrations of antibiotics in influent, effluent, and sludge from urban WWTPs in China are 786.2 ng/L, 311.2 ng/L, and 186.8 μg/kg, respectively. Among the detected antibiotics, 42% exhibit moderate to high ecological risk in the effluent, with ciprofloxacin, sulfamethoxazole, erythromycin, azithromycin, and tetracycline posing moderate to high ecological risks in sludge. The current biological treatment processes in WWTPs demonstrate inefficacy in removing antibiotics. Hence, there is a pressing need to develop and integrate innovative technologies, such as advanced oxidation processes. This review aims to offer a more comprehensive understanding and identify priority antibiotics for control to effectively manage antibiotic pollution within WWTPs at both national and regional levels.