Pharmaceuticals have received extensive scientific and socio-economic attention worldwide due to their acute and chronic toxic effects on plants, animals, and human health. However, the geographical distribution and seasonal variability of pharmaceutical mixtures in aquatic environments remain underexplored, especially in resource-deficient countries. The present review provides an in-depth analysis of the seasonal occurrence of pharmaceuticals, particularly antibiotics detected over the last five years in surface water, groundwater, and drinking water. The effectiveness of the conventional and advanced drinking water treatment processes is discussed with a focus on the adsorption and ozonation processes, commonly employed at drinking water treatment plants (DWTPs). Findings reveal median concentrations of antibiotics and other pharmaceuticals in drinking water worldwide, often exceeding their levels in groundwater. This underscores the urgent need for global-scale, long-term monitoring of antibiotics in aquatic systems, especially in DWTPs. Beyond targeted analysis, non-targeted analysis (NTA) should be integrated into routine water quality monitoring at DWTPs to identify novel contaminants, including fluorinated pharmaceuticals. Finally, this review provides an overview concerning the process-based and data-driven modelling of pharmaceutical occurrence, fate, and transport as a complementary approach to sampling and lab-scaled experiments, especially in resource-limited settings. Strengthening long-term monitoring, expanding treatment solutions, integrating modelling tools, and promoting green chemistry innovations are crucial to mitigating risks and safeguarding water quality.

Sludge generated at sewage treatment plants is of environmental concern due to the voluminous production and the presence of a high concentration of emerging contaminants (ECs). This review discusses the fate of ECs in sewage sludge treatment with an emphasis on fundamental mechanisms driving the degradation of compounds based on chemical properties of the contaminant and process operating conditions. The removal of ECs in sewage sludge through various treatment processes of sludge stabilization, such as anaerobic digestion (AD), composting, and pre-treatment methods (thermal, sonication, and oxidation) followed by AD, are discussed. Several transformation mechanisms and remediation strategies for the removal of ECs in sludge are summarized. The study concludes that pH, sludge type, and the types of functional groups are the key factors affecting the sorption of ECs to sludge. During conventional waste stabilization processes such as composting, the degradation of ECs depends on the type of feedstock (TOC, N, P, C/N, C/P) and the initial concentration of the contaminant. In AD, the degree of degradation depends on the hydrophilicity of the compound. The estrogenicity of the sludge may sometimes increase due to the conversion to estrogenic compounds. The pre-treatment techniques can increase the partitioning of ECs in the soluble fraction resulting in enhanced biodegradation up to 10–60%. However, the formation of by-products and loss of OH· to scavenging under high organic content during advanced oxidation processes can make the process uneconomical and require further research.