Effective methods for removal of antibiotic pollutants from wastewater: sources, pathways, distribution, and impacts

The global reliance on antibiotics has led to the discharge of large amounts of their residues into rivers, lakes, and coastal waters. Antibiotic residues, even in small amounts, can damage ecosystems and human health. They can also lead to the development of antibiotic-resistant bacteria and genes. This review applies a source-impact-treatment framework to connect major antibiotic classes, usage patterns, and transport pathways with resistance-related environmental and public health concerns. Unlike reviews that focus on a single technology or material, this work provides a decision-oriented comparison of the two most widely used removal strategies: adsorption and advanced oxidation processes (AOPs). Recent advances are summarized by highlighting key materials, processes, performance trends, mechanisms, and practical limitations. Adsorption and AOPs are evaluated using unified criteria, including treatment cost, operating conditions, mineralization and by-product formation, toxicity reduction, and implementation challenges. This framework supports context-specific selection for various wastewater matrices and regional requirements, Moreover, this work identifies research gaps and future directions, such as the development of robust, low-cost materials, enhancement of mineralization with reduced secondary risks. In addition, it emphasizes the need to integrate treated wastewater reuse to more effectively assess sustainability and real-world applicability.