Occurrence, Environmental Risk, and Treatment of Erythromycin in Water: A Systematic Study and Meta-analysis

Erythromycin (ERY) is an antibiotic widely used to treat infectious diseases in animals and humans. However, its presence in water can have effects on health and the environment. The objective of this study was to analyze globally reported ERY concentrations in water, the risks these concentrations pose to aquatic organisms and antimicrobial resistance, and the advanced oxidation processes (AOPs) used to remove this emerging contaminant from water. The methodology consisted of an exploratory-descriptive systematic study and a critical meta-analysis in the study area. The results showed that the ERY concentrations found in different countries ranged from 0.2 ng/L to 252824 ng/L. It was determined that 40.74% of the maximum reported concentrations represent a high ecological risk to aquatic organisms, while 25.93% represent a potential risk of antimicrobial resistance. As an alternative to this global problem, AOPs such as the nickel ferrite photocatalyst incorporated into chitosan, and photo-electro-Fenton, electro-Fenton, and oxalic acid-assisted photo-electro-Fenton systems have been used, achieving removals close to 100% of the initial dose of ERY in the studied water. However, it is concluded that the degradation by-products, as well as the technical, economic, and environmental viability of these advanced treatments, and their potential for deactivating bacteria and antimicrobial resistance genes, should be further analyzed considering a future scale-up.