The continuous discharge of pharmaceutical residues into aquatic environments has become a significant environmental concern. Effluents from healthcare facilities, pharmaceutical manufacturing, and domestic sources contain active pharmaceutical ingredients (APIs), antibiotics, hormones, and personal care products that pose ecological and human health risks due to their toxicity, persistence, and mutagenic properties. This review evaluates current and emerging treatment strategies, with emphasis on biological, nanomaterial-based, and integrated bionanotechnological approaches for pharmaceutical wastewater remediation. Conventional wastewater treatment plants show limited efficiency in removing pharmaceutical contaminants, leading to their continuous release into aquatic systems and contributing to ecological toxicity and antibiotic resistance. Recent studies highlight the effectiveness of biological approaches, including bacterial, plant-, and algal-based systems, as well as nanomaterial-based technologies such as adsorptive and catalytic nanomaterials. However, these approaches are often limited when applied independently. Emerging research demonstrates that integrating nanomaterials with biological systems into nano–bio hybrid platforms significantly enhances treatment performance. Examples include enzyme-functionalized nanomaterials, magnetic nanoparticle-based biocatalytic systems, and multifunctional nanocomposites. This review provides a comprehensive overview of pharmaceutical wastewater sources, characteristics, and treatment technologies, including standalone biological and nanomaterial-based approaches, followed by their integration. Particular emphasis is placed on nano–bio interaction mechanisms, including adsorption-mediated pollutant concentration, nanomaterial-assisted enzymatic biodegradation, and metabolic priming effects, which improve enzyme stability and degradation efficiency. Key challenges such as scalability, environmental safety, and economic feasibility are highlighted. Future research should focus on developing sustainable and scalable hybrid technologies for effective pharmaceutical wastewater management.
Ghazi et al. (Mon,) studied this question.