In this study, we analyzed 27 pharmaceuticals in liquid and solid phase samples collected from the unit processes of four different sewage treatment plants (STPs) to evaluate their distribution and behavior of the pharmaceuticals. The examination of the relative distributions of various categories of pharmaceuticals in the influent showed that non-steroidal anti-inflammatory drugs (NSAIDs) were the most dominant. While the relative distribution of antibiotics in the influent was not high (i.e., 3%–5%), it increased to 14%–30% in the effluent. In the four STPs, the mass load of the target pharmaceuticals was reduced by 88%–95% mainly in the biological treatment process, whereas the ratio of pharmaceuticals in waste sludge to those in the influent (w/w) was only 2%. In all the STPs, the removal efficiencies for the stimulant caffeine, NSAIDs (acetaminophen, naproxen, and acetylsalicylic acid), and the antibiotic cefradine were high; they were removed mainly by biological processes. Certain compounds, such as the NSAID ketoprofen, contrast agent iopromide, lipid regulator gemfibrozil, and antibiotic sulfamethoxazole, showed varying removal efficiencies depending on the contribution of biodegradation and sludge sorption. In addition, a quantitative meta-analysis was performed to compare the pharmaceutical removal efficiencies of the biological treatment processes in the four STPs, which were a membrane bioreactor (MBR) process, sequencing batch reactor (SBR) process, anaerobic–anoxic–oxic (A2O) process, and moving-bed biofilm reactor (MBBR) process. Among the biological processes, the removal efficiency was in the order of MBR > SBR > A2O > MBBR. Among the tertiary treatment processes investigated, powdered activated carbon showed the highest removal efficiency of 18%–63% for gemfibrozil, ibuprofen, ketoprofen, atenolol, cimetidine, and trimethoprim.

In this study, livestock wastewater treatment plants in South Korea were monitored to determine the characteristics of influent and effluent wastewater, containing four types of veterinary antibiotics (sulfamethazine, sulfathiazole, chlortetracycline, oxytetracycline), and the removal efficiencies of different treatment processes. Chlortetracycline had the highest average influent concentration (483.7 μg/L), followed by sulfamethazine (251.2 μg/L), sulfathiazole (230.8 μg/L) and oxytetracycline (25.7 μg/L), at five livestock wastewater treatment plants. Sulfathiazole had the highest average effluent concentration (28.2 μg/L), followed by sulfamethazine (20.8 μg/L) and chlortetracycline (11.5 μg/L), while no oxytetracycline was detected. For veterinary antibiotics in the wastewater, a removal efficiency of at least 90% was observed with five types of treatment processes, including a bio-ceramic sequencing batch reactor, liquid-phase flotation, membrane bioreactor, bioreactor plus ultrafiltration (BIOSUF) and bio best bacillus systems. Moreover, this study evaluated the removal efficiency via laboratory-scale experiments on the conventional contaminants, such as organic matter, nitrogen, phosphorus and veterinary antibiotics. This was done using the hydraulic retention time (HRT), under three temporal conditions (14 h, 18 h, 27 h), using the anaerobic–anoxic–oxic (A2O) process, in an attempt to assess the combined livestock wastewater treatment process where the livestock wastewater is treated until certain levels of water quality are achieved, and then the effluent is discharged to nearby sewage treatment plants for further treatment. The removal efficiencies of veterinary antibiotics, especially oxytetracycline and chlortetracycline, were 86.5–88.8% and 87.9–90.8%, respectively, exhibiting no significant differences under various HRT conditions. The removal efficiency of sulfamethazine was at least 20% higher at HRT = 27 h than at HRT = 14 h, indicating that sulfamethazine was efficiently removed in the A2O process with increased HRT. This study is expected to promote a comprehensive understanding of the behavior and removal of veterinary antibiotics in the livestock wastewater treatment plants of South Korea.