Dissipation and persistence of sulfonamides, quinolones and tetracyclines in anaerobically digested biosolids and compost during short-term storage under natural conditions

Tetracycline antibiotics in agricultural soil: Dissipation kinetics, transformation pathways, and structure-related toxicity

Tetracyclines (TCs) are the most common antibiotics in agricultural soil, due to their widespread usage and strong persistence. Biotic and abiotic degradation of TCs may generate toxic transformation products (TPs), further threatening soil ecological safety. Despite the increasing attention on the environmental behavior of TCs, a systematic review on the dissipation of TCs, evolution of TPs, and structure-toxicity relationship of TCs in agricultural soil remains lacking. This review aimed to provide a comprehensive overview of the environmental fate of TCs in agricultural soil. We first introduced the development history and structural features of different generations of TCs. Then, we comparatively evaluated the dissipation kinetics, transportation pathways, and ecological impacts of three representative TCs, namely tetracycline (TC), oxytetracycline (OTC), and chlortetracycline (CTC), in agricultural soil. The results showed that the dissipation kinetics of TCs generally followed the first-order kinetic model, with the median dissipation half-lives ranging from 20.0 to 38.8 days. Among the three TCs, OTC displayed the lowest dissipation rates due to its structural stability. The typical degradation pathways of TCs in soil included epimerization/isomerization, demethylation, and dehydration. Isomerization and dehydration reactions may lead to the formation of more toxic TPs, while demethylation was accompanied by the alteration of the minimal pharmacophore of TCs thus potentially reducing the toxicity. Toxicological experiments are urgently needed in future to comprehensively evaluate the ecological risks of TCs in agricultural soil.

Development of a 3-step sequential extraction method to investigate the fraction and affecting factors of 21 antibiotics in soils

Antibiotic exist in various states after entering agricultural soil through the application of manure, including the aqueous state (I), which can be directly absorbed by plants, and the auxiliary organic extraction state (III), which is closely associated with the pseudo-permanence of antibiotics. However, effective analytical methods for extracting and affecting factors on fractions of different antibiotic states remain unclear. In this study, KCl, acetonitrile/Na2EDTA-McIlvaine buffer, and acetonitrile/water were successively used to extract states I, II, and III of 21 antibiotics in soil, and the recovery efficiency met the quantitative requirements. Random forest classification and variance partitioning analysis revealed that dissolved organic matter, pH, and organic matter were important factors affecting the recovery efficiency of antibiotic in states I, II, and III, respectively. Additionally, 65-day spiked soil experiments combined with Mantel test analysis suggested that pH, organic acids, heavy metals, and noncrystalline minerals differentially affected antibiotic type and state. Importantly, a structural equation model indicated that organic acids play a crucial role in the fraction of antibiotic states. Overall, this study reveals the factors influencing the fraction of different antibiotic states in soil, which is helpful for accurately assessing their ecological risk.

Risk control of antibiotics, antibiotic resistance genes (ARGs) and antibiotic resistant bacteria (ARB) during sewage sludge treatment and disposal: A review

Sewage sludge is an important reservoir of antibiotics, antibiotic resistance genes (ARGs), and antibiotic resistant bacteria (ARB) in wastewater treatment plants (WWTPs), and the reclamation of sewage sludge potentially threats human health and environmental safety. Sludge treatment and disposal are expected to control these risks, and this review summarizes the fate and controlling efficiency of antibiotics, ARGs, and ARB in sludge involved in different processes, i.e., disintegration, anaerobic digestion, aerobic composting, drying, pyrolysis, constructed wetland, and land application. Additionally, the analysis and characterization methods of antibiotics, ARGs, and ARB in complicate sludge are reviewed, and the quantitative risk assessment approaches involved in land application are comprehensively discussed. This review benefits process optimization of sludge treatment and disposal, with regard to environmental risks control of antibiotics, ARGs, and ARB in sludge. Furthermore, current research limitations and gaps, e.g., the antibiotic resistance risk assessment in sludge-amended soil, are proposed to advance the future studies.

Occurrence and fate of antibiotics in swine waste treatment: An industrial case

This study mapped the fate of antibiotics in a swine farm with integrated waste treatment including anoxic stabilization, fixed-film anaerobic digestion, anoxic-oxic (A/O), and composting. Results show the prevalent and consistent occurrence of 12 antibiotics in swine waste. Mass balance of these antibiotics was calculated to track their flow and evaluate their removal by different treatment units. The integrated treatment train could effectively reduce antibiotic loading to the environment by 90% (measured as combined mass of all antibiotic residues). Within the treatment train, anoxic stabilization as the initial treatment step, accounted for the highest contribution (43%) to overall antibiotic elimination. Results also show that aerobic was more effective than anaerobic regarding antibiotic degradation. Composting accounted for an additional of 31% removal of antibiotics while anaerobic digestion contributed to 15%. After treatment, antibiotic residues in the treated effluent and composted materials were 2 and 8% of the initial antibiotic loading in raw swine waste, respectively. Ecological risk assessment showed negligible or low risk quotient associated with most individual antibiotics released into the aquatic environment or soil from swine farming. Nevertheless, antibiotic residues in treated water and composted materials together showed significant ecological risk to water and soil organisms. Thus, further work to improve treatment performance or develop new technologies is necessary to reduce the impact of antibiotics from swine farming.

Composting Processes for Agricultural Waste Management: A Comprehensive Review

Composting is the most adaptable and fruitful method for managing biodegradable solid wastes; it is a crucial agricultural practice that contributes to recycling farm and agricultural wastes. Composting is profitable for various plant, animal, and synthetic wastes, from residential bins to large corporations. Composting and agricultural waste management (AWM) practices flourish in developing countries, especially Pakistan. Composting has advantages over other AWM practices, such as landfilling agricultural waste, which increases the potential for pollution of groundwater by leachate, while composting reduces water contamination. Furthermore, waste is burned, open-dumped on land surfaces, and disposed of into bodies of water, leading to environmental and global warming concerns. Among AWM practices, composting is an environment-friendly and cost-effective practice for agricultural waste disposal. This review investigates improved AWM via various conventional and emerging composting processes and stages: composting, underlying mechanisms, and factors that influence composting of discrete crop residue, municipal solid waste (MSW), and biomedical waste (BMW). Additionally, this review describes and compares conventional and emerging composting. In the conclusion, current trends and future composting possibilities are summarized and reviewed. Recent developments in composting for AWM are highlighted in this critical review; various recommendations are developed to aid its technological growth, recognize its advantages, and increase research interest in composting processes.

Human health risk estimation of antibiotics transferred from wastewater and soil to crops

Antibiotics enter into agricultural land, via manure application or wastewater irrigation. The practices of using untreated wastewater in the agricultural system help in the bioaccumulation of antibiotics in vegetables and other crops. Exposure to the bioaccumulated antibiotics poses serious health risks to ecosystem and human. In this study, the prevalence of two fluoroquinolones (levofloxacin and ciprofloxacin), their bioaccumulation in five crops (Daucus carota L., Pisum sativum L., Raphanus raphanistrum L., Lactuca sativa L., Spinacia oleracea L.), and associated human health risks were investigated. Lettuce showed highest bioaccumulation of levofloxacin (LEV) (12.66 μg kg-1) and carrot showed high bioaccumulation of ciprofloxacin (CIP) (13.01 μg kg-1). In roots, bioconcentration factor (BCFroot) was observed to be relatively high in radish (LEV 0.24-0.43, CIP 0.32-0.49) and observed to be lower in spinach (LEV 0.05-0.13, CIP 0.12-0.19). The translocation factor (TF) for LEV and CIP was generally >1 for all five crops under all treatment. The final transfer and distribution of LEV and CIP in the edible parts of the crops were as follows: leaves > shoots > roots for both antibiotics. Risk quotient of both LEV and CIP in current study is found to be in between 0.018 and 0.557 and shows a medium risk (0.1 to 1) to human health due the discharge of untreated wastewater into the fields. However, our study reports that both antibiotics do accumulate in the edible plant parts; therefore, it poses potential risks to human health.

Source, occurrence and risks of twenty antibiotics in vegetables and soils from facility agriculture through fixed-point monitoring and numerical simulation

In this study, a universal method that combined fixed-point monitoring and numerical simulation was used to understand the source, fate and risks of antibiotics in environment. Results showed that the antibiotic concentration in vegetables, soil and manure from 53 fixed-point monitoring sampling sites were ND-18.47, ND-1438.50 and ND-24710.00 μg kg^-1, respectively. There were positive correlations between the antibiotic concentrations of vegetables and soil as well as between soil and manure. The average Amount_soil/manure values were 1.48-46.02, indicating that antibiotics built up pseudo persistent residues in soil due to repeated fertilization. The modified level-III fugacity model showed that tetracyclines and fluoroquinolones tend to remain in soil given their sorption and mobility, while sulfonamides were highly distributed in plants, especially in leaves. Norfloxacin, ofloxacin, sulfadiazine, sulfamethoxazole and sulfisoxazole were found to be risk factors in facility agriculture and should be continuously monitored during agricultural production. Most importantly, we used the inversion method to determine the recommended maximum residue limits of antibiotics in soil. This will not only allow for better control of the amount of the antibiotics in the environment, but also act as a potential method to assess the risks of pollutants without maximum residue limits in the environment.

Contrasted effects of Metaphire guillelmi on tetracycline diffusion and dissipation in soil

Earthworms are important in soil bioremediation because of their capability of pollutant degradation. However, the trade-off between pollutant dissemination and degradation arising from earthworm activities remains unclear, as well as the potential biodegradation mechanism. Herein, an earthworm avoidance experiment was established to investigate Metaphire guillelmi-mediated tetracycline (TC) diffusion and degradation. The results showed that above 1600 mg kg^-1 TC pollution in soil induced avoidance behaviour of earthworms (p < 0.05), below which the random worm behaviour accelerated TC diffusion by 8.2% at most (p < 0.05), resulting in elevated levels of antibiotic-resistant bacteria and genes in the soil. Nevertheless, earthworms enhanced TC degradation regardless of whether their avoidance behaviour occurred (14.6-25.8%, p < 0.05). Compared with in soil, metabolic pathways affiliated with xenobiotic degradation and metabolism in the intestines were enriched (LDA >3). Given the abundant glutathione S-transferases in the intestines and their close relationship with Δ degradation, they may play a key role in intestinal TC biodegradation. In general, earthworms had good tolerance to soil TC contamination and their impact on promoting TC degradation outweighed that accelerating TC diffusion. This work provides a comprehensive view of earthworms as a potential remediation method for TC-contaminated soil.

Assessment of the occurrence of 455 pharmaceutical compounds in sludge according to their physical and chemical properties: A review

Sludge agronomical reuse is of major interest due to the beneficial contribution of nutrients. However, it implies the introduction of unregulated pharmaceuticals into amended-soils and creates a controversial issue about sludge management. To limit their dissemination, it is essential to identify the compounds of interest and understand their attenuation mechanisms through the sludge processes. This paper summarizes the knowledge on 455 investigated pharmaceuticals among 32 therapeutical categories in amendable sludge matrices. It contributes to enlarging the list of commonly quantified compounds to 305 residues including 84 additional compounds compared to previous reviews. It highlights that sorption appears as the main mechanism controlling the occurrence of pharmaceuticals in sludge matrices and shows the considerable residual levels of pharmaceuticals reaching several mg/kg in dry weight. Antibiotics, stimulants, and antidepressants show the highest concentrations up to 232 mg/kg, while diuretics, anti-anxieties or anticoagulants present the lowest concentrations reaching up to 686 µg/kg. Collected data show the increase in investigated compounds as antifungals or antihistamines, and underline emerging categories like antidiabetics, antivirals, or antiarrhythmics. The in-depth analysis of the substantial database guides onto the pharmaceuticals that are the most likely to occur in these amendable matrices to assist future research.

The mechanism of uptake and translocation of antibiotics by pak choi (Brassica rapa subsp. chinensis)

Antibiotic uptake by vegetables from the environment is one pathway in which humans are exposed to antibiotics through the food chain and can pose potential risks to human health. Therefore, understanding the mechanism of how antibiotics enter vegetables will contribute to developing effective measures to reduce antibiotic contamination in crops. In this study, a series of hydroponic experiments were conducted to investigate the uptake and translocation of six antibiotics in pak choi. The results showed the accumulation capacity of fluoroquinolones was significantly higher than that of tetracycline and sulfamethoxypyridazine. The antibiotic uptake kinetics in roots were well described by the Michaelis-Menten equation. The results for the metabolic inhibitor, aquaporin inhibitor, and transpiration inhibitor showed that the uptake processes for ofloxacin, norfloxacin, and enrofloxacin were energy-dependent, those for sulfamethoxypyridazine and ciprofloxacin were aquaporin-dependent, and that for tetracycline was energy- and aquaporin-dependent. Antibiotic translocation was associated with water transport through xylem vessels, which could be controlled by aquaporin activities and transpiration. Roots were the main accumulator of antibiotics, and the degradation percentages of tetracycline, norfloxacin, enrofloxacin, and ofloxacin by Pak choi were 0-14.48% within 72 h. Overall, our findings provide a better understanding of the transfer of antibiotics from the environment to vegetables, which will be of great significance for developing optimal management practices to mitigate antibiotic contamination in vegetables and ensuring food safety.

Microbial community structures and antibiotic biodegradation characteristics during anaerobic digestion of chicken manure containing residual enrofloxacin

To explore the interaction between the residual antibiotic in animal manure and biological treatment, the effect of enrofloxacin (ENR) on the anaerobic digestion of chicken manure, and biodegradation rate of ENR was studied under the condition of actual residual ENR content of 0, 8, 16 and 32 mg/kg·TS. The results showed that the addition of ENR increased the total biogas production, especially 8 mg/kg·TS promoted the anaerobic reaction obviously, and the corresponding cumulative biogas production was increased by 15.33%. However, in the presence of 32 mg/kg·TS, the biogas production rate was reduced and the peak period of biogas production was delayed. The results of enzyme activities determination and 16S rRNA sequencing showed that ENR had different effects on archaea and bacteria. The residual ENR could promote hydrolysis reactions in the anaerobic system, but could inhibit acetoclastic methanogens, and the relative abundance of Methanosaeta declined by 7.22‒12.41%. The first-order kinetic model showed that the half-life period of ENR in the anaerobic digestion system was 9.16‒10.83 days, and the biodegradation rate exceeded 80% after the treatment. This study can bring important information for the management of animal manure in the future.

Determination of multiple antibiotics in agricultural soil using a quick, easy, cheap, effective, rugged, and safe method coupled with ultra-high performance liquid chromatography-tandem mass spectrometry

In this study, we combined ultra-high performance liquid chromatography with tandem mass spectrometry to establish a quick, easy, cheap, effective, rugged, and safe method of detecting 21 target antibiotics in agricultural soil samples. Antibiotics were extracted with mixed solvents consisting of ethylenediaminetetraacetic acid disodium salt dihydrate and phosphoric acid citric acid buffer and acetonitrile which were purified with octadecylsilyl as an adsorbent and anhydrous sodium sulfate as a desiccant. This method was able to effectively extract all of the target antibiotics from agricultural soils, with recovery efficiencies ranging from 55 to 108% and limits of detection between 0.09-0.68 μg/kg. We also validated this new method for selectivity, sensitivity, and reliability of detecting multiple antibiotics in 12 samples. Considering the potential environmental and public health effects of antibiotics in agricultural soils, our new method can help analyze the degree of antibiotic contamination and provide valuable information for soil quality and risk assessment.

Simultaneous determination of pharmaceuticals and metabolites in fish tissue by QuEChERS extraction and UHPLC Q/Orbitrap MS analysis

In recent years, the occurrence, fate, and adverse effects of pharmaceutically active compounds (PhACs) in aquatic organisms have become a noteworthy issue. In the present study, a rapid and sensitive multiresidue analytical method was developed for the determination of 18 parent PhACs and 5 metabolites in sea bream (Sparus aurata), by combining a modified QuEChERS (quick, easy, cheap, effective, rugged and safe) procedure with ultra-high performance liquid chromatography-Orbitrap-mass spectrometry (UHPLC-Orbitrap-MS). The method development involved optimization of extraction solvent, extraction salts, clean-up sorbents, and amount of sample evaluation, while identification on Orbitrap MS was based on accurate mass and further confirmation with MS/MS fragmentation. The developed method was validated, and linearity was higher than 0.99. Recoveries in all cases ranged between 62 and 107% (at 10, 50, and 100 ng g^-1), while intra-day and inter-day precision, expressed as relative standard deviation, RSD, was lower than 4% and 7%, respectively. In addition, limits of quantification (LOQs) ranged between 0.5 and 19 ng g^-1. The compounds presented a low matrix effect, between - 13 and 4%, while the expanded uncertainty U% estimated at the three spiking levels 10, 50, and 100 ng g^-1 was found below 49% in all cases. Finally, the validated method was applied to sea bream samples from an aquaculture farm located in the Mediterranean Sea, with one positive finding for the antibiotic trimethoprim at a concentration of 26 ng g^-1, presenting negligible human health risk.

Phytoextraction of ciprofloxacin and sulfamethoxaxole by cattail and switchgrass

Cattail (Typha latifolia L.) and switchgrass (Panicum virgatum L.) can effectively remove inorganic contaminants from soils and biosolids, but their role in the attenuation of organic contaminants, such as antimicrobials, is currently poorly understood. Uptake by plants is one of several mechanisms by which plant-assisted attenuation of antimicrobials can be achieved. The objectives of this growth room study were to evaluate the plant uptake of ciprofloxacin (CIP) and sulfamethoxazole (SMX) and examine their partitioning between plant roots and aboveground biomass (AGB). Plant uptake of the two ¹⁴C labeled antimicrobials was studied at two environmentally relevant concentrations (5 and 10 μg L^-1). Plants were destructively sampled every 3-4 d during the 21-d growth period. Accumulation of CIP and SMX in both plant species was greater in the roots than in the AGB. The percentage uptake values of the two antimicrobials were significantly greater for cattail (34% for CIP, 20% for SMX) than for switchgrass (10% for both CIP and SMX). Translocation factors of the two antimicrobials were <1 for both plants, indicating slow movement of the antimicrobials from the roots to the shoots. For cattail roots, the BCF for CIP (1.58 L g^-1) was significantly greater than that for SMX (0.8 L g^-1). By comparison, BCFs for switchgrass roots did not differ significantly between CIP (0.88 L g^-1) and SMX (1.13 L g^-1). These results indicate greater potential for cattail to phytoextract CIP and SMX and significantly contribute to the attenuation of these antimicrobials in systems designed for the phytoremediation of contaminated wastewater.

Dissipation Dynamics of Doxycycline and Gatifloxacin and Accumulation of Heavy Metals during Broiler Manure Aerobic Composting

In this study, broilers were fed with heavy-metal-containing diets (Zn, Cu, Pb, Cr, As, Hg) at three rates (T1: 5 kg premix/ton feed, T2: 10 kg premix/ton feed and T3: 15 kg premix/ton feed) and Doxycycline (DOX) and Gatifloxacin (GAT) at low or high doses (T4: 31.2 mg DOX/bird/day and 78 mg GAT/bird/day, T5: 15.6 mg DOX/bird/day and 48 mg GAT/bird/day) to assess the accumulation of various heavy metals and the fate of two antibiotics in broiler manure after 35 days of aerobic composting. The results indicated that the two antibiotics changed quite differently during aerobic composting. About 14.96–15.84% of Doxycycline still remained at the end of composting, while Gatifloxacin was almost completely removed within 10 days of composting. The half-lives of Doxycycline were 13.75 and 15.86 days, while the half-lives of Gatifloxacin were only 1.32 and 1.38 days. Based on the Redundancy analysis (RDA), the concentration of antibiotics was significantly influenced by physico-chemical properties (mainly temperature and pH) throughout the composting process. Throughout the composting process, all heavy metal elements remained concentrated in organic fertilizer. In this study the Cr content reached 160.16 mg/kg, 223.98 mg/kg and 248.02 mg/kg with increasing premix feed rates, similar to Zn, which reached 258.2 mg/kg, 312.21 mg/kg and 333.68 mg/kg. Zn and Cr concentrations well exceeded the United States and the European soil requirements. This experiment showed that antibiotic residues and the accumulation of heavy metals may lead to soil contamination and pose a risk to the soil ecosystem.

Assessment of veterinary antibiotics from animal manure-amended soil to growing alfalfa, alfalfa silage, and milk

Using animal manure as organic fertilizer to grow fodder crops is causing public health concerns because animal manure is the major reservoir of veterinary antibiotics. In this study, we used a mathematical model to estimate the risk of human exposure to veterinary antibiotics when using swine manure as organic fertilizer to grow alfalfa (Medicago sativa L.). Alfalfa was planted in a greenhouse and fertilized with swine manure spiked with oxytetracycline (OTC, at 0, 150, and 1500 mg/kg of manure), ofloxacin (OFL, at 0, 15, and 150 mg/kg), or sulfamonomethoxine (SMM, at 0, 5, 15 and 150 mg/kg). Alfalfa was harvested at the budding stage and ensiled for 60 days. Results showed that OTC and OFL could be detected in the alfalfa root, stem, and leaf with a concentration ranging from 8.85 to 59.17 μg OTC /kg and from 1.50 to 4.10 μg OFL/kg dry matter, but SMM could only be detected in the root ranging from 29.10 to 63.75 μg/kg dry matter. The ensiling for 60 days decreased the OFL concentration by 68.7% but only slightly decreased the OTC concentration. The maximum daily exposures of humans to OTC and OFL through liquid milk consumption were estimated to be 5.84E-8 and 1.63E-8 μg, respectively, both of which are well below the intake levels of OTC (72 μg) and OFL (54 μg) mandated by the European Union. The results of the present study indicate that using swine manure as organic fertilizer to grow alfalfa poses a limited risk for human exposure to veterinary antibiotics through the consumption of liquid milk.

Effects of two ecological earthworm species on tetracycline degradation performance, pathway and bacterial community structure in laterite soil

This study explored the change of tetracycline degradation efficiency, metabolic pathway, soil physiochemical properties and degraders in vermiremediation by two earthworm species of epigeic Eisenia fetida and endogeic Amynthas robustus. We found a significant acceleration of tetracycline degradation in both earthworm treatments, and 4-epitetracycline dehydration pathway was remarkably enhanced only by vermiremediation. Tetracycline degraders from soils, earthworm intestines and casts were different. Ralstonia and Sphingomonas were potential tetracycline degraders in soils and metabolized tetracycline through direct dehydration pathway. Degraders in earthworm casts (Comamonas, Acinetobacter and Stenotrophomonas) and intestines (Pseudomonas and Arthrobacter) dehydrated 4-epitetracycline into 4-epianhydrotetracycline. More bacterial lineages resisting tetracycline were found in earthworm treatments, indicating the adaptation of soil and intestinal flora under tetracycline pressure. Earthworm amendment primarily enhanced tetracycline degradation by neutralizing soil pH and consuming organic matters, stimulating both direct dehydration and epimerization-dehydration pathways. Our findings proved that vermicomposting with earthworms is effective to alter soil microenvironment and accelerate tetracycline degradation, behaving as a potential approach in soil remediation at tetracycline contaminated sites.

Dissipation of sulfamethoxazole and trimethoprim during temporary storage of biosolids: A microcosm study

Little is known about the dissipation rate of microcontaminants in biosolids during storage and stabilization in stockpiles (unsaturated) or storage lagoons/tanks (saturated). The objective of this study was to characterize the dissipation in biosolids of two antibiotics, sulfamethoxazole (SMX) and trimethoprim (TMP), in microcosms under saturated and unsaturated conditions that simulate biosolids that are stockpiled on land or deposited in lagoons/tanks, respectively. The laboratory experiment was conducted at 22 °C using biosolids spiked at an initial nominal concentration of 10 mg kg^-1 for both antibiotics. Biosolids were sampled in triplicate at seven sampling times over a 42-d period. Concentrations of SMX and TMP in extracts prepared from biosolids were quantified using liquid chromatography with tandem mass spectrometry. Dissipation data fitted to a first-order kinetic model indicated that the time to 50% dissipation (DT₅₀) for SMX was significantly shorter in the unsaturated microcosms (2.8 d) than the saturated microcosms (4.4 d), while the DT₅₀ for TMP was significantly shorter in microcosms under saturated conditions (10 d) relative to unsaturated conditions (116 d). These results indicate that the reducing conditions that develop in biosolids deposited in lagoons or placed in storage tanks might be effective for enhancing the microbial degradation of antibiotics that are otherwise persistent under aerobic conditions (i.e., TMP), while also being effective for removing other antibiotics including those that dissipate relatively readily under aerobic conditions (i.e., SMX).

Fate of antibiotics during membrane separation followed by physical-chemical treatment processes

Membrane separation technology has been widely utilised to obtain clean permeate and concentrated nutrients from biogas digested slurry. However, some antibiotics are frequently found in digested slurry. Antibiotic removal during the steps, including paper filtration (PF), hollow-fibre membrane ultrafiltration (HF), nanofiltration (NF) and reverse osmosis (RO), of combined membrane separation processing (CMP) remain poorly understood. Experiments were performed on a pilot-scale CMP plant to investigate antibiotic transport and rejection efficiencies in CMP products and analyse the antibiotic removal performances of additional treatments. Results showed average relative antibiotic rejection efficiencies of 50%, 83%, 28% and 14% for PF, HF, NF and RO during CMP, respectively. Each CMP product needed additional treatment for antibiotic removal. Antibiotic removal capacity followed the order of fine halloysite > P25 > activated charcoal > coarse halloysite. The average antibiotic removal rates for different CMP products ranged from 73.3% to 99.9%. But antibiotics can only be adsorbed by fine halloysite and must be degraded through other treatments, Thus, P25 has considerable practical importance for the removal of antibiotics, as antibiotics can be degraded during photocatalysis.