Skip to main content
SpringerLink
Log in

Removal efficiency of commonly prescribed antibiotics via tertiary wastewater treatment

  • Review Article
  • Published:
Environmental Science and Pollution Research Aims and scope Submit manuscript

Abstract

Wastewater treatment plants (WWTPs) have been identified as “hot spots” of antibiotics release to the environment. Treatment operations at WWTPs may remove a significant proportion of antibiotics from influent wastewater; however, the effects of tertiary treatment processes on antibiotics removal are not well understood. The objective of this review is to summarize the current literature regarding antibiotics removal from common tertiary processes at full-scale municipal WWTPs and to reveal the research gaps and inform future research directions. Chlorination, ultraviolet (UV) irradiation, and sand filtration were reviewed due to their popularity of application in the USA. The majority of studies of antibiotics removal via tertiary wastewater treatment have been conducted in EU nations, the USA, Australia, and China. Chlorination significantly reduces antibiotics concentrations in wastewater effluents. In comparison, sand filtration and UV irradiation are less effective. However, a large discrepancy of removal efficiencies is apparent across different studies of these treatment processes. Increases in antibiotics concentration following tertiary treatment have also been observed. Possible reasons for the discrepancies, such as sorption to filtered particles, sampling strategies, specific operating parameters of wastewater treatment plants, and deconjugation, are discussed. It is concluded that the effects of tertiary treatment on antibiotic removal efficiency are still arguable, and caution must be taken when sampling wastewater in full-scale WWTPs for comparison of removal efficiencies of antibiotics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Adams C, Wang Y, Loftin K, Meyer M (2002) Removal of antibiotics from surface and distilled water in conventional water treatment processes. J Environ Eng 128(3):253–260

    Article  CAS  Google Scholar 

  • Alajmi HM (2014) Effect of physical, chemical and biological treatment on the removal of five pharmaceuticals from domestic wastewater in laboratory-scale reactors and full-scale plant. (Ph.D.), Newcastle University, Newcastle. Retrieved from http://hdl.handle.net/10443/2469. Accessed 14 Jan 2019

  • Altmann J, Ruhl AS, Zietzschmann F, Jekel M (2014) Direct comparison of ozonation and adsorption onto powdered activated carbon for micropollutant removal in advanced wastewater treatment. Water Res 55:185–193

    Article  CAS  Google Scholar 

  • Batt AL, Bruce IB, Aga DS (2006) Evaluating the vulnerability of surface waters to antibiotic contamination from varying wastewater treatment plant discharges. Environ Pollut 142(2):295–302

    Article  CAS  Google Scholar 

  • Batt AL, Kim S, Aga DS (2007) Comparison of the occurrence of antibiotics in four full-scale wastewater treatment plants with varying designs and operations. Chemosphere 68(3):428–435

    Article  CAS  Google Scholar 

  • Ben W, Zhu B, Yuan X, Zhang Y, Yang M, Qiang Z (2018) Occurrence, removal and risk of organic micropollutants in wastewater treatment plants across China: comparison of wastewater treatment processes. Water Res 130:38–46

    Article  CAS  Google Scholar 

  • Bendz D, Paxéus NA, Ginn TR, Loge FJ (2005) Occurrence and fate of pharmaceutically active compounds in the environment, a case study: Höje River in Sweden. J Hazard Mater 122(3):195–204

    Article  CAS  Google Scholar 

  • Blair B, Nikolaus A, Hedman C, Klaper R, Grundl T (2015) Evaluating the degradation, sorption, and negative mass balances of pharmaceuticals and personal care products during wastewater treatment. Chemosphere 134:395–401

    Article  CAS  Google Scholar 

  • Bokare AD, Choi W (2014) Review of iron-free Fenton-like systems for activating H2O2 in advanced oxidation processes. J Hazard Mater 275:121–135

    Article  CAS  Google Scholar 

  • Burton FL, Stensel HD, Tchobanoglous G (2014) Wastewater engineering: treatment and resource recovery. McGraw-Hill Education, New York

    Google Scholar 

  • Carballa M, Omil F, Ternes T, Lema JM (2007) Fate of pharmaceutical and personal care products (PPCPs) during anaerobic digestion of sewage sludge. Water Res 41(10):2139–2150

    Article  CAS  Google Scholar 

  • De la Cruz N, Giménez J, Esplugas S, Grandjean D, De Alencastro L, Pulgarin C (2012) Degradation of 32 emergent contaminants by UV and neutral photo-Fenton in domestic wastewater effluent previously treated by activated sludge. Water Res 46(6):1947–1957

    Article  CAS  Google Scholar 

  • Deborde M, Von Gunten U (2008) Reactions of chlorine with inorganic and organic compounds during water treatment—kinetics and mechanisms: a critical review. Water Res 42(1–2):13–51

    Article  CAS  Google Scholar 

  • Demain AL (2014) Importance of microbial natural products and the need to revitalize their discovery. J Ind Microbiol Biotechnol 41(2):185–201

    Article  CAS  Google Scholar 

  • EPA U. S. (2012) Clean watersheds needs survey. U.S. Environmental Protection Agency, Washington, DC. Retrieved from https://ofmpub.epa.gov/apex/cwns2012/f?p=134:1. Accessed 14 Jan 2019

  • Fair RJ, Tor Y (2014) Antibiotics and bacterial resistance in the 21st century. Perspectives in Medicinal Chemistry. https://doi.org/10.4137/PMC.S14459

  • Gao S, Zhao Z, Xu Y, Tian J, Qi H, Lin W, Cui F (2014) Oxidation of sulfamethoxazole (SMX) by chlorine, ozone and permanganate—a comparative study. J Hazard Mater 274:258–269

    Article  CAS  Google Scholar 

  • Ghosh GC, Okuda T, Yamashita N, Tanaka H (2009) Occurrence and elimination of antibiotics at four sewage treatment plants in Japan and their effects on bacterial ammonia oxidation. Water Sci Technol 59:779–786

    Article  CAS  Google Scholar 

  • Giger W, Alder AC, Golet EM, Kohler H-PE, McArdell CS, Molnar E, Siegrist H, Suter MJ-F (2003) Occurrence and fate of antibiotics as trace contaminants in wastewaters, sewage sludges, and surface waters. CHIMIA Int J Chemistry 57(9):485–491

    Article  CAS  Google Scholar 

  • Gleckman R, Blagg N, Joubert DW (1981) Trimethoprim: mechanisms of action, antimicrobial activity, bacterial resistance, pharmacokinetics, adverse reactions, and therapeutic indications. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 1(1):14–19

  • Göbel A, McArdell CS, Joss A, Siegrist H, Giger W (2007) Fate of sulfonamides, macrolides, and trimethoprim in different wastewater treatment technologies. Sci Total Environ 372(2–3):361–371

    Article  CAS  Google Scholar 

  • Golet EM, Xifra I, Siegrist H, Alder AC, Giger W (2003) Environmental exposure assessment of fluoroquinolone antibacterial agents from sewage to soil. Environ Sci Technol 37(15):3243–3249

    Article  CAS  Google Scholar 

  • Gothwal R, Shashidhar T (2015) Antibiotic pollution in the environment: a review. Clean–Soil, Air, Water 43(4):479–489

    Article  CAS  Google Scholar 

  • Gulkowska A, Leung HW, So MK, Taniyasu S, Yamashita N, Yeunq LWY, Richardson BJ, Lei AP, Giesy JP, Lam PKS (2008) Removal of antibiotics from wastewater by sewage treatment facilities in Hong Kong and Shenzhen, China. Water Res 42(1–2):395–403

    Article  CAS  Google Scholar 

  • Hirsch R, Ternes T, Haberer K, Kratz K-L (1999) Occurrence of antibiotics in the aquatic environment. Sci Total Environ 225(1–2):109–118

    Article  CAS  Google Scholar 

  • Hollender J, Zimmermann SG, Koepke S, Krauss M, McArdell CS, Ort C, Singer H, von Gunten U, Siegrist H (2009) Elimination of organic micropollutants in a municipal wastewater treatment plant upgraded with a full-scale post-ozonation followed by sand filtration. Environ Sci Technol 43(20):7862–7869

    Article  CAS  Google Scholar 

  • Jelic A, Gros M, Ginebrenda A, Cespedes-Sánchez R, Ventura F, Petrovic M et al (2011) Occurrence, partition and removal of pharmaceuticals in sewage water and sludge during wastewater treatment. Water Res 45:1165–1176

    Article  CAS  Google Scholar 

  • Jia A, Wan Y, Xiao Y, Hu J (2012) Occurrence and fate of quinolone and fluoroquinolone antibiotics in a municipal sewage treatment plant. Water Res 46(2):387–394

    Article  CAS  Google Scholar 

  • Joss A, Zabczynski S, Göbel A, Hoffmann B, Löffler D, McArdell CS, … Siegrist H (2006) Biological degradation of pharmaceuticals in municipal wastewater treatment: proposing a classification scheme. Water Res 40(8):1686–1696

  • Kang G-d, Cao Y-m (2012) Development of antifouling reverse osmosis membranes for water treatment: a review. Water Res 46(3):584–600

    Article  CAS  Google Scholar 

  • Karthikeyan K, Meyer MT (2006) Occurrence of antibiotics in wastewater treatment facilities in Wisconsin, USA. Sci Total Environ 361(1–3):196–207

    Article  CAS  Google Scholar 

  • Kim S, Eichhorn P, Jensen JN, Weber AS, Aga DS (2005) Removal of antibiotics in wastewater: effect of hydraulic and solid retention times on the fate of tetracycline in the activated sludge process. Environ Sci Technol 39(15):5816–5823

    Article  CAS  Google Scholar 

  • Kim I, Yamashita N, Tanaka H (2009) Performance of UV and UV/H2O2 processes for the removal of pharmaceuticals detected in secondary effluent of a sewage treatment plant in Japan. J Hazard Mater 166(2–3):1134–1140

    Article  CAS  Google Scholar 

  • Klein EY, Van Boeckel TP, Martinez EM, Pant S, Gandra S, Levin SA, Goossens H, Laxminarayan R (2018) Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc Natl Acad Sci 115(15):E3463–E3470. https://doi.org/10.1073/pnas.1717295115

  • Kulkarni P, Olson ND, Raspanti GA, Rosenberg Goldstein RE, Gibbs SG, Sapkota A, Sapkota AR (2017) Antibiotic concentrations decrease during wastewater treatment but persist at low levels in reclaimed water. Int J Environ Res Public Health 14(6):668

    Article  CAS  Google Scholar 

  • Kümmerer K (2009) Antibiotics in the aquatic environment–a review–part I. Chemosphere 75(4):417–434

    Article  CAS  Google Scholar 

  • Le-Minh N, Khan S, Drewes J, Stuetz R (2010) Fate of antibiotics during municipal water recycling treatment processes. Water Res 44(15):4295–4323

    Article  CAS  Google Scholar 

  • Levy SB, Marshall B (2004) Antibacterial resistance worldwide: causes, challenges and responses. Nat Med 10(12s):S122–S129

    Article  CAS  Google Scholar 

  • Li B, Zhang T (2011) Mass flows and removal of antibiotics in two municipal wastewater treatment plants. Chemosphere 83(9):1284–1289

    Article  CAS  Google Scholar 

  • Li X, Zheng W, Kelly WR (2013) Occurrence and removal of pharmaceutical and hormone contaminants in rural wastewater treatment lagoons. Sci Total Environ 445:22–28

    Article  CAS  Google Scholar 

  • Li J, Cheng W, Xu L, Jiao Y, Baig SA, Chen H (2016) Occurrence and removal of antibiotics and the corresponding resistance genes in wastewater treatment plants: effluents’ influence to downstream water environment. Environ Sci Pollut Res 23(7):6826–6835

    Article  CAS  Google Scholar 

  • Lin AY-C, Tsai Y-T (2009) Occurrence of pharmaceuticals in Taiwan’s surface waters: impact of waste streams from hospitals and pharmaceutical production facilities. Sci Total Environ 407(12):3793–3802

    Article  CAS  Google Scholar 

  • Lin AY-C, Yu T-H, Lateef SK (2009) Removal of pharmaceuticals in secondary wastewater treatment processes in Taiwan. J Hazard Mater 167(1–3):1163–1169

    Article  CAS  Google Scholar 

  • Lindberg RH, Wennberg P, Johansson MI, Tysklind M, Andersson BA (2005) Screening of human antibiotic substances and determination of weekly mass flows in five sewage treatment plants in Sweden. Environ Sci Technol 39(10):3421–3429

    Article  CAS  Google Scholar 

  • Lindberg RH, Olofsson U, Rendahl P, Johansson MI, Tysklind M, Andersson BA (2006) Behavior of fluoroquinolones and trimethoprim during mechanical, chemical, and active sludge treatment of sewage water and digestion of sludge. Environ Sci Technol 40(3):1042–1048

  • Lindberg RH, Björklund K, Rendahl P, Johansson MI, Tysklind M, Andersson BA (2007) Environmental risk assessment of antibiotics in the Swedish environment with emphasis on sewage treatment plants. Water Res 41(3):613–619

    Article  CAS  Google Scholar 

  • Luo Y, Guo W, Ngo HH, Nghiem LD, Hai FI, Zhang J, Liang S, Wang XC (2014) A review on the occurrence of micropollutants in the aquatic environment and their fate and removal during wastewater treatment. Sci Total Environ 473:619–641

    Article  CAS  Google Scholar 

  • Margot J, Kienle C, Magnet A, Weil M, Rossi L, De Alencastro LF, Abegglen C, Thonney D, Chèvre N, Schärer M (2013) Treatment of micropollutants in municipal wastewater: ozone or powdered activated carbon? Sci Total Environ 461:480–498

    Article  CAS  Google Scholar 

  • Miao X-S, Bishay F, Chen M, Metcalfe CD (2004) Occurrence of antimicrobials in the final effluents of wastewater treatment plants in Canada. Environ Sci Technol 38(13):3533–3541

    Article  CAS  Google Scholar 

  • Michael I, Rizzo L, McArdell C, Manaia C, Merlin C, Schwartz T, Dagot C, Fatta-Kassinos D (2013) Urban wastewater treatment plants as hotspots for the release of antibiotics in the environment: a review. Water Res 47(3):957–995

    Article  CAS  Google Scholar 

  • Miege C, Choubert J, Ribeiro L, Eusèbe M, Coquery M (2009) Fate of pharmaceuticals and personal care products in wastewater treatment plants–conception of a database and first results. Environ Pollut 157(5):1721–1726

    Article  CAS  Google Scholar 

  • Nakada N, Shinohara H, Murata A, Kiri K, Managaki S, Sato N, Takada H (2007) Removal of selected pharmaceuticals and personal care products (PPCPs) and endocrine-disrupting chemicals (EDCs) during sand filtration and ozonation at a municipal sewage treatment plant. Water Res 41(19):4373–4382

    Article  CAS  Google Scholar 

  • Nam S-W, Choi D-J, Kim S-K, Her N, Zoh K-D (2014) Adsorption characteristics of selected hydrophilic and hydrophobic micropollutants in water using activated carbon. J Hazard Mater 270:144–152

    Article  CAS  Google Scholar 

  • Obst U, Schwartz T, Volkmann H (2006) Antibiotic resistant pathogenic bacteria and their resistance genes in bacterial biofilms. Int J Artif Organs 29(4):387–394

    Article  CAS  Google Scholar 

  • Peng X, Wang Z, Kuang W, Tan J, Li K (2006) A preliminary study on the occurrence and behavior of sulfonamides, ofloxacin and chloramphenicol antimicrobials in wastewaters of two sewage treatment plants in Guangzhou, China. Sci Total Environ 371(1–3):314–322

    Article  CAS  Google Scholar 

  • Pérez S, Eichhorn P, Aga DS (2005) Evaluating the biodegradability of sulfamethazine, sulfamethoxazole, sulfathiazole, and trimethoprim at different stages of sewage treatment. Environ Toxicol Chem 24(6):1361–1367

    Article  Google Scholar 

  • Polesel F, Andersen HR, Trapp S, Plosz BG (2016) Removal of antibiotics in biological wastewater treatment systems—a critical assessment using the activated sludge modeling framework for xenobiotics (ASM-X). Environ Sci Technol 50(19):10316–10334

    Article  CAS  Google Scholar 

  • Prabhasankar VP, Joshua DI, Balakrishna K, Siddiqui IF, Taniyasu S, Yamashita N, Kannan K, Akiba M, Praveenkumarreddy Y, Guruge KS (2016) Removal rates of antibiotics in four sewage treatment plants in South India. Environ Sci Pollut Res 23(9):8679–8685

    Article  CAS  Google Scholar 

  • Quach-Cu J, Herrera-Lynch B, Marciniak C, Adams S, Simmerman A, Reinke RA (2018) The effect of primary, secondary, and tertiary wastewater treatment processes on antibiotic resistance gene (ARG) concentrations in solid and dissolved wastewater fractions. Water 10(1):37

    Article  CAS  Google Scholar 

  • Rice LB (2008) Federal funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. The University of Chicago Press, Chicago

    Book  Google Scholar 

  • Rizzo L, Manaia C, Merlin C, Schwartz T, Dagot C, Ploy M, Michael I, Fatta-Kassinos D (2013) Urban wastewater treatment plants as hotspots for antibiotic resistant bacteria and genes spread into the environment: a review. Sci Total Environ 447:345–360

    Article  CAS  Google Scholar 

  • Roberts PH, Thomas KV (2006) The occurrence of selected pharmaceuticals in wastewater effluent and surface waters of the lower Tyne catchment. Sci Total Environ 356(1–3):143–153

    Article  CAS  Google Scholar 

  • Roberts DM, Liu X, Roberts JA, Nair P, Cole L, Roberts MS, Lipman J, Bellomo R (2015) A multicenter study on the effect of continuous hemodiafiltration intensity on antibiotic pharmacokinetics. Crit Care 19(1):84

    Article  Google Scholar 

  • Roberts J, Kumar A, Du J, Hepplewhite C, Ellis DJ, Christy AG, Beavis SG (2016) Pharmaceuticals and personal care products (PPCPs) in Australia’s largest inland sewage treatment plant, and its contribution to a major Australian river during high and low flow. Sci Total Environ 541:1625–1637

    Article  CAS  Google Scholar 

  • Senta I, Terzic S, Ahel M (2013) Occurrence and fate of dissolved and particulate antimicrobials in municipal wastewater treatment. Water Res 47(2):705–714

  • Senta I, Krizman I, Ahel M, Terzic S (2014) Assessment of stability of drug biomarkers in municipal wastewater as a factor influencing the estimation of drug consumption using sewage epidemiology. Sci Total Environ 487:659–665

    Article  CAS  Google Scholar 

  • Sharpless CM, Linden KG (2001) UV photolysis of nitrate: effects of natural organic matter and dissolved inorganic carbon and implications for UV water disinfection. Environ Sci Technol 35(14):2949–2955

    Article  CAS  Google Scholar 

  • Snyder SA, Adham S, Redding AM, Cannon FS, DeCarolis J, Oppenheimer J, Wert EC, Yoon Y (2007) Role of membranes and activated carbon in the removal of endocrine disruptors and pharmaceuticals. Desalination 202(1–3):156–181

    Article  CAS  Google Scholar 

  • Suarez S, Lema JM, Omil F (2010) Removal of pharmaceutical and personal care products (PPCPs) under nitrifying and denitrifying conditions. Water Res 44(10):3214–3224

    Article  CAS  Google Scholar 

  • Ternes TA, Bonerz M, Herrmann N, Teiser B, Andersen HR (2007) Irrigation of treated wastewater in Braunschweig, Germany: an option to remove pharmaceuticals and musk fragrances. Chemosphere 66:894–904

    Article  CAS  Google Scholar 

  • Van Doorslaer X, Dewulf J, Van Langenhove H, Demeestere K (2014) Fluoroquinolone antibiotics: an emerging class of environmental micropollutants. Sci Total Environ 500:250–269

    Article  CAS  Google Scholar 

  • Verlicchi P, Al Aukidy M, Zambello E (2012) Occurrence of pharmaceutical compounds in urban wastewater: removal, mass load and environmental risk after a secondary treatment—a review. Sci Total Environ 429:123–155

    Article  CAS  Google Scholar 

  • Wang J, Wang S (2016) Removal of pharmaceuticals and personal care products (PPCPs) from wastewater: a review. J Environ Manag 182:620–640

    Article  CAS  Google Scholar 

  • Wang JL, Xu LJ (2012) Advanced oxidation processes for wastewater treatment: formation of hydroxyl radical and application. Crit Rev Sci Technol 42(3):251–325

    Article  CAS  Google Scholar 

  • Watkinson A, Murby E, Costanzo S (2007) Removal of antibiotics in conventional and advanced wastewater treatment: implications for environmental discharge and wastewater recycling. Water Res 41(18):4164–4176

    Article  CAS  Google Scholar 

  • Westerhoff P, Yoon Y, Snyder S, Wert E (2005) Fate of endocrine-disruptor, pharmaceutical, and personal care product chemicals during simulated drinking water treatment processes. Environ Sci Technol 39(17):6649–6663

    Article  CAS  Google Scholar 

  • Xu W, Zhang G, Li X, Zou S, Li P, Hu Z, Li J (2007) Occurrence and elimination of antibiotics at four sewage treatment plants in the Pearl River Delta (PRD), South China. Water Res 41(19):4526–4534

    Article  CAS  Google Scholar 

  • Yang S, Cha J, Carlson K (2005) Simultaneous extraction and analysis of 11 tetracycline and sulfonamide antibiotics in influent and effluent domestic wastewater by solid-phase extraction and liquid chromatography-electrospray ionization tandem mass spectrometry. J Chromatogr A 1097(1–2):40–53

    Article  CAS  Google Scholar 

  • Yang W, Zhou H, Cicek N (2014) Treatment of organic micropollutants in water and wastewater by UV-based processes: a literature review. Crit Rev Environ Sci Technol 44(13):1443–1476

    Article  CAS  Google Scholar 

Download references

Funding

This publication was made possible by the Ball State New Faculty Startup under fund number 120198, Ball State ASPiRE Grant Program: Graduate Student Research Support under award number A17-0419-001, and Ball State University Digital Scholarship Lab Award under award number A18-0399-001.

Author information

Authors and Affiliations

  1. Department of Natural Resources and Environmental Management, Ball State University, Muncie, IN, USA

    Kayla D. Burch, Bangshuai Han & John Pichtel

  2. Department of Chemistry, Ball State University, Muncie, IN, USA

    Tykhon Zubkov

Authors
  1. Kayla D. Burch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bangshuai Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Pichtel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tykhon Zubkov
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bangshuai Han.

Additional information

Responsible editor: Ester Heath

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Burch, K.D., Han, B., Pichtel, J. et al. Removal efficiency of commonly prescribed antibiotics via tertiary wastewater treatment. Environ Sci Pollut Res 26, 6301–6310 (2019). https://doi.org/10.1007/s11356-019-04170-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11356-019-04170-w

Keywords

Search

Navigation