Recent occurrence of pharmaceuticals in freshwater, emerging treatment technologies, and future considerations: A review

Pharmaceuticals represent an emerging class of pollutants raising significant environmental health concerns, with their presence in freshwater systems linked to adverse aquatic ecosystem impacts and acceleration of antibiotic resistance development. This narrative review examines recent (2019-2024) pharmaceutical occurrences in freshwater globally, analyzes contamination pathways, evaluates compound-specific degradability, and assesses treatment technologies. Analysis revealed significant pharmaceutical contamination in freshwater sources across the six major continents, primarily entering through wastewater treatment plant effluents, groundwater recharge processes, and inadequate sanitation…