How far do we still need to go with antibiotics in aquatic environments? Antibiotic occurrence, chemical-free or chemical-limited strategies, key challenges, and future perspectives.

Global consumption and progressive migration of antibiotics through aquatic systems have contributed to their rapid spread, posing significant threats to environmental and human health, and antibiotics have been recognized as emerging pollutants. Hence, extensive approaches have been proposed for antibiotic treatment in water, yielding great achievements. This review systematically summarized current knowledge from contamination characteristics to treatment strategies. First, the prevalence and characteristics of antibiotics in aquatic environments were discussed and chemical-free or chemical-limited strategies were subsequently reviewed, i.e. adsorption, membrane separation, electrochemistry, and photocatalysis. Thereafter, gaps were identified between conditions for treatment in aquatic environments and lab-scale experiments, emphasizing that simulated antibiotic concentrations in laboratory studies were often hundreds of times higher than those found in natural settings and lack consideration of complex water matrices. Additionally, concerns regarding health risks arose due to unexpectedly low mineralization rates. For future advancements, hybrid or combined technologies were recommended, along with the integration of smart tools such as machine learning for deeper insights into degradation processes and cross-risk assessments. This review offers valuable guidance for establishing effective strategies to control antibiotics in aquatic environments.