Urban wastewater treatment plants (UWTPs) are among the main sources of antibiotics’
release into various compartments of the environment worldwide. The aim of the present
paper is to critically review the fate and removal of various antibiotics in wastewater
treatment, focusing on different processes (i.e. biological processes, advanced treatment
technologies and disinfection) in view of the current concerns related to the induction of
toxic effects in aquatic and terrestrial organisms, and the occurrence of antibiotics that
may promote the selection of antibiotic resistance genes and bacteria, as reported in the
literature. Where available, estimations of the removal of antibiotics are provided along
with the main treatment steps. The removal efficiency during wastewater treatment
processes varies and is mainly dependent on a combination of antibiotics’ physicochemical
properties and the operating conditions of the treatment systems. As a result, the
application of alternative techniques including membrane processes, activated carbon
adsorption, advanced oxidation processes (AOPs), and combinations of them, which may
lead to higher removals, may be necessary before the final disposal of the effluents or their
reuse for irrigation or groundwater recharge.