The occurrence and elimination of seventeen antibiotics (three macrolides: azithromycin, clarithromycin and roxithromycin; five quinolones: ciprofloxacin, enrofloxacin, levofloxacin, nalidixic acid and norfloxacin; five sulfonamides: sulfadimethoxine, sulfadimizine, sulfamerazine, sulfamethoxazole and sulfamonomethoxine; and others: tetracycline, lincomycin, salinomycin and trimethoprim) were investigated at four full-scale sewage treatment plants in Japan. The highest concentration was recorded for clarithromycin (1,129 to 4,820 ng/L) in influent, followed by azithromycin (160 to 1,347 ng/L), levofloxacin (255 to 587 ng/L) and norfloxacin (155 to 486 ng/L). A vary inconsistence picture was obtained with negative to over 90% removal. Nalidixic acid (53 to100%) exhibited higher removal efficiency followed by norfloxacin (75 to 95%), levofloxacin (40 to 90%), ciprofloxacin (60 to 83%) and enrofloxacin (38 to 74%). Among macrolides, clarithromycin (50 to 88%) and azithromycin (34 to 86%) showed relatively higher removal efficiency than roxithromycin (−32 to 59%). For most of the antibiotics removal efficiency was higher in A2O and AO based secondary treatment process than CAS process. The effect of the antibiotics on bacterial ammonia oxidation determined by oxygen uptake rate presented that there was no significant effect below 0.05 mg/L of each antibiotics. Even at the same concentration, antibiotics in mixed condition had higher inhibition effects than individuals.

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