Sulfamethoxazole degradation pathways in wastewater treatment: Bayesian network-based approach for a meta-analysis of scientific papers.

Given the widespread presence of micropollutants in urban water systems, it is imperative to gain a comprehensive understanding of their degradation pathways. This paper focuses on sulfamethoxazole (SMX) as a model molecule due to its extensive study, aiming to elucidate its degradation pathways in biological (BIO) and oxidative (AOP) processes. Numerous reaction pathways are outlined in scientific papers. However, a significant deficiency in current methodologies has led to the development of a novel meta-analytical approach, seeking consensus among researchers by synthesizing data from studies characterized by their heterogeneity and contradictions. As an innovative alternative, probabilistic graphical models such as Bayesian networks (BNs) could illuminate the relationships and dependencies between various transformation products, providing a holistic view of the degradation process. Based on the analysis of an extensive bibliography gathering more than 45 articles for more than 140 molecules and 177 reaction pathways, this study proposes a meta-analysis methodology based on Bayesian networks.

Insights into the efficient removal and mechanism of NiFeAl-LDH with abundant hydroxyl to activate peroxymonosulfate for sulfamethoxazole wastewater.

Layered double hydroxide (LDH) material with abundant OH was successfully prepared by co-precipitation method, and a water purification system of Ni2Fe0.25Al0.75-LDH activated peroxymonosulfate (PMS) was constructed to rapidly degrade sulfamethoxazole (SMX) pollutants. The optimal conditions for the degradation of SMX in the system were as follows: 0.30 g/L Ni2Fe0.25Al0.75-LDH, 0.30 mM PMS, pH = 7 and 90 % SMX was removed in 10 min and almost completely in 40 min, which was consistent with the predicted results of response surface methodology (RSM) analysis. The abundant OH in Ni2Fe0.25Al0.75-LDH could form M(O)OSO3 complexes with PMS, accelerating the generation of reactive oxygen species (ROS) and promoting the removal of SMX. Quenching experiments and electron paramagnetic resonance (EPR) spectra showed that SO4-, OH, O2- and 1O2 also existed in the system. The surface-bound SO4- and O2- contributed greatly to the removal of SMX and the electron transfer between metals was also conducive to the production of active substances. The possible degradation pathways and intermediates of SMX were proposed. The toxicity assessment software tool (T.E.S.T) and total organic carbon (TOC) results indicated that the Ni2Fe0.25Al0.75-LDH/PMS system could reduce the overall environmental risk of SMX to some extent. This study provided a new strategy for the practical application of heterogeneous catalysts in sewage treatment.

The fate of sulfamethoxazole in microcosms of the macrophyte Schoenoplectus californicus and its impact on microbial communities.

Sulfamethoxazole is a widely used antibiotic frequently found as an environmental pollutant. It can alter microbial communities and increase antibiotic resistance, becoming a public health risk. Constructed wetlands have the potential for removing sulfamethoxazole from polluted waters, but the role of different macrophytes in this process is not well understood. We investigated the fate of sulfamethoxazole and its effect on bacterial communities in microcosms containing Schoenoplectus californicus, an altitude-tolerant macrophyte. Within the first 10 h after introducing sulfamethoxazole (initial concentration 5 mg/L) to the microcosms, the concentration in the liquid phase significantly differed between microcosms with and without S. californicus. However, over the long term (15 and 30 days post-addition), the removal percentage (around 75%) in the liquid phase was not significantly influenced by S. californicus, indicating that sediments might be primarily responsible for removing the antibiotic. The presence of S. californicus promoted algae growth in the microcosms, and we determined that algae contributed to sulfamethoxazole removal from the liquid phase, likely through adsorption. Additionally, we characterized bacterial communities in the microcosm sediments via nanopore sequencing to identify changes following sulfamethoxazole addition. The relative abundance of Proteobacteria increased from 37-46% to 48-99% with the addition of the antibiotic. Conversely, the relative abundance of cyanobacteria decreased significantly after sulfamethoxazole was added (from 17 to 35% to less than 2%), suggesting it may serve as a biological marker for sulfamethoxazole pollution. In addition, the functional profile of the community was estimated from taxonomic diversity using PICRUST.

Insights on aggregation-algae consortium based removal of sulfamethoxazole: Unraveling removal effect, enhanced method and toxicological evaluation.

The escalating occurrence of the antibiotic Sulfamethoxazole (SMX) in the environment presents a significant global threat to ecological systems and human health. Despite the growing interest in using microalgae for antibiotic biodegradation, strategies to enhance SMX elimination remain underexplored. In this study, we isolated a novel aggregation-algae consortium (AAC) from a municipal wastewater treatment plant (WWTP) and examined its potential for SMX removal, optimized culture conditions, SMX metabolite fate and the physicochemical impact on microalgal cells. The findings revealed that the AAC demonstrated remarkable resistance to SMX, even at concentrations as high as 10 mg/L, and could degrade SMX via free radical reactions. Although ion repulsion limited the biodegradation of AAC, the addition of peptone and yeast extract resulted in a significant enhancement, increased by 16.71%, 39.12% and 46.77% of three SMX groups. Moreover, AAC exhibited exceptional adaptability in real wastewater, achieving removal of 87.05%, 97.39% and 20.80% for total dissolved nitrogen, total dissolved phosphorus and SMX, respectively. The decreased degradation toxicity of SMX following AAC treatment was further validated by ECOSAR software and in vitro tests using Caenorhabditis elegans. This study advanced our understanding of SMX biodegradation and provided a novel approach for treating wastewater contaminated with SMX.

Anaerobic dynamic membrane bioreactor treating sulfamethoxazole wastewater: advantages of dynamic membrane and its fouling mechanism.

Discharge of improperly treated sulfamethoxazole (SMX) wastewater seriously threats environmental security and public health. Anaerobic dynamic membrane bioreactors (AnDMBRs) technology would be cost-effective for SMX wastewater treatment, considering its low cost and satisfactory treatment efficiency. The performance of AnDMBR, though demonstrated to be excellent in treating many types of wastewaters, was for the first time investigated for treating SMX wastewater. Particular efforts were devoted to elucidating the advantages of dynamic membrane (DM) and the governing mechanism responsible for DM fouling with the presence of SMX. The threshold SMX concentration for AnDMBR was found to be 90 mg/L and the AnDMBR exhibited excellent removal efficiency of COD (90.91 %) and SMX (88.95 %) as well as satisfactory acute toxicity reduction rate (88.84 %). It was noteworthy that the DM made indispensable contributions to the removal of COD (14.26 %) and SMX (22.20 %) as well as the acute reduction of toxicity (25.81 %). The presence of SMX significantly accelerated DM fouling mainly by increasing its specific resistance, which was attributed to the increased content of small particles, high-valence metal ions and EPS content (mainly hydrophobic proteins), resulting in a denser DM structure with lower porosity. Besides, the biofouling-related bacteria (Firmicutes) was found to be enriched in the DM with the presence of SMX.

Use of trimethoprim- sulfamethoxazole for treating Pneumocystis jirovecii pneumonia in a patient with glucose-6-phosphate dehydrogenase deficiency: a case report.

Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection caused by the yeast-like fungus P. jirovecii. As recommended by some guidelines, the first-line treatment for this infection is trimethoprim-sulfamethoxazole (TMP-SMX), and the second-line treatment includes drugs such as dapsone, pentamidine, primaquine, Atovaquone, clindamycin, and caspofungin. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked gene disorder in which treatment with oxidizing drugs, such as sulfonamides, dapsone, primaquine, can directly destroy hemoglobin present in red blood cells (RBCs), thereby inducing methemoglobin and hemolysis. Case presentation: Here, we present the case of a lymphoma patient with previous G6PD deficiency who was admitted to ICU for the treatment of severe pneumonia combined with respiratory failure. PJP was detected by the next-generation sequencing of the bronchoalveolar lavage fluid. The patient was initially treated with the antifungal drug caspofungin; however, this treatment showed poor therapeutic effect. Based on the evaluation of G6PD enzyme activity and the patient's previous history of G6PD deficiency, we finally treated the patient with low-dose TMP-SMX combined with caspofungin and provided rigorous medical care to the patient. Following this treatment, the patient's clinical symptoms improved, lung computed tomography showed reduced pulmonary inflammation, and the fungal ß-(1,3)-D-glucan test (G test) showed decreased levels of fungal D-glucan. After 57 days, the TMP-SMX treatment was discontinued. No symptoms related to G6PD deficiency, such as hemolysis, hematuria, and anemia, occurred during the treatment course. Conclusion: This is the first report mentioning the successful treatment of Pneumocystis jirovecii pneumonia with a double-drug regimen with low-dose TMP-SMX and caspofungin in a T-lymphoblastic leukemia/lymphoma patient with previous G6PD deficiency. Enzyme activity detection is the first step for anti-PJP treatment in patients with G6PD deficiency. Although patients with mild enzyme deficiency may not show any adverse reactions, we still recommend the regular monitoring of the levels of RBCs, hemoglobin, and hematocrit before and after the use of sulfonamides or sulfoxides and other oxidizing drugs in patients with G6PD deficiency. Among other things, early and correct diagnosis of Pneumocystis jirovecii pneumonia in hematological malignancies patients is very important. Relevant oncologists should be alert to the risk of Pneumocystis jirovecii pneumonia in these patients.

Atmospheric pressure dielectric barrier discharge plasma for in-situ water treatment using a bubbling reactor.

Non-thermal plasma has been an emerging technology for water treatment for decades. In this study, we have designed and fabricated a bubbling plasma batch reactor using an atmospheric pressure dielectric barrier discharge with a hydrophobic porous membrane. The reactor performance is assessed for purifying synthetic contaminated water samples containing chemical contaminant sulfamethoxazole (SMX), a widely used antibiotic, and biological contaminant E. coli K12. The SMX decontamination tests indicate that the degradation process is not first-order and the reaction rate dwindle with increasing initial concentration. The yield at 50% removal achieves its highest value of 8.12 g/kWh for 50 mg/L SMX sample. For inactivation of E. coli K12 tests, the inactivation process is also not first-order, and the pathogen is completely inactivated for 102 CFU/mL and 104 CFU/mL cases after 10 min and 45 min of plasma treatment, respectively. For the 108 CFU/mL sample, a 5-log reduction is achieved after 60 min of treatment. The developed plasma reactor can achieve fast deployment in point of use, low cost for manufacturing, and simple for maintenance. Moreover, it can be used for in-situ water purification in future long duration crewed space missions as well as tackling with water pollution issues on our planet.

Comparison of High-Dose versus Low-Dose Trimethoprim-Sulfamethoxazole for Treating Pneumocystis jirovecii Pneumonia among Hemodialysis Patients: A Nationwide Database Study in Japan.

Background: Hemodialysis patients are at high risk for developing Pneumocystis jirovecii pneumonia (PJP), and trimethoprim-sulfamethoxazole (TMP-SMX) is the first-line agent for treating this disease. However, there is a lack of consensus on the required dosage of TMP-SMX for hemodialysis patients. Methods: This study used the nationwide Japanese Diagnosis Procedure Combination database to review hemodialysis patients hospitalized for PJP from April 2014 to March 2022. Eligible patients were divided into high-dose and low-dose groups based on the median daily dose per body weight of TMP. The 90-day mortality and adverse events after propensity score matching were compared between the groups. Results: A total of 126 hemodialysis patients with PJP were included, and the median daily dose per body weight of TMP was 5.74 mg/kg/day (interquartile range: 4.33-8.18 mg/kg/day). Thirty-two pairs were analyzed after the propensity score matching. No significant differences in the 90-day mortality and proportion of adverse events were observed between the high-dose and low-dose groups. Conclusions: A high dose of TMP-SMX is unlikely to decrease the in-hospital mortality and adverse events among hemodialysis patients with PJP. However, the results should be interpreted with caution, given the lack of power and lack of long-term follow-up. Additional prospective interventional studies are required to validate these results.

Nitrate Enhanced Sulfamethoxazole Degradation by 222 nm Far-UVC Irradiation: Role of Reactive Nitrogen Species.

The application of 222 nm far-UVC irradiation for degrading organic micropollutants in water shows promise. Nitrate (NO3-), found in nearly all water bodies, can significantly impact the performance of 222 nm far-UVC-driven systems. This work was the first to investigate the effect of NO3- on sulfamethoxazole (SMX) photodegradation at 222 nm, finding that NO3- significantly enhances SMX degradation in different dissociated forms. Besides the hydroxyl radical (•OH), reactive nitrogen species (RNS) also played important roles in SMX degradation. With increasing NO3- concentration, the RNS contribution to SMX degradation decreased from 25.7 to 8.6% at pH 3 but increased from 1.5 to 24.7% at pH 7, since the deprotonated SMX with electron-rich groups reacted more easily with RNS. The transformation mechanisms of SMX involving isomerization, bond cleavage, hydroxylation, nitrosation, and nitration processes were proposed. 15N isotope labeling experiments showed that the RNS-induced nitrated products even became the major products of SMX in the 222 nm far-UVC/NO3- system at pH 7 and exhibited a higher toxicity than SMX itself. Further research is necessary to avoid or eliminate these toxic byproducts. This study provides valuable insights for guiding the utilization of 222 nm far-UVC for treating antibiotics in NO3--containing water.

Valorizing waste activated sludge incineration ash to S-doped Fe2+@Zeolite 4A catalyst for the treatment of emerging contaminants exemplified by sulfamethoxazole.

The global attention towards waste management and valorization has led to significant interest in recovering valuable components from sludge incineration ash (SIA) for the synthesis of functional environmental materials. In this study, the SIA was converted to an S-doped Fe2+-zeolite type catalyst (FZA) for the treatment of emerging contaminants (ECs), exemplified by sulfamethoxazole (SMX). Results demonstrate that FZA effectively catalyzed the activation of peracetic acid (PAA), achieving a remarkable degradation of 99.8% under optimized conditions. Mechanistic investigations reveal that the FZA/PAA system can generate ·OH, 1O2, O2·ï¼, and Fe(Ⅳ), with ·OH playing a dominant role in ECs degradation. Additionally, the doped S facilitated electrochemical performance, Fe2+ regeneration and fixation in FZA. Practical application elucidated that the FZA/PAA system can work in complex environments to degrade various ECs without generating high-toxicity ingredients. Overall, valorizing SIA to FZA provides dual achievement in waste management and ECs removal.

Mechanism of adsorption and targeted degradation of antimicrobial micropollutant sulfamethoxazole in aquatic environments.

FHWSB as an integrated absorptive catalyst, based on Walnut shell biochar (WSB) via hydrochloric acid modification and ferrous chloride impregnation, was prepared, reacted with H2O2 to generate active free radicals •OH and •O2-, which oxidized and degraded about 80% of micro-pollutant sulfamethoxazole (SMX) from water, effectively resolving micro-pollutants' removal being inefficient because of high toxicity, persistence, and bioaccumulation in existed methods. It was clarified the specific degradation pathways and mechanisms of SMX by FHWSB synergistic H2O2 via characterization and analysis assisted DFT calculations. Furthermore, it was found that the toxicity of a series of intermediates produced by SMX degraded continued to decline, consistent with its direction of degradation via toxicological analysis. The work provides a simple and feasible strategy for the effective removal of antibiotic micro-pollutants in aquatic environments.

Intermittent Versus Daily Trimethoprim/Sulfamethoxazole Regimens for Pneumocystis Pneumonia Prophylaxis: A Systematic Review and Meta-analysis.

Background: In immunocompromised individuals, trimethoprim/sulfamethoxazole (TMP/SMX) for Pneumocystis pneumonia (PCP) prophylaxis has adverse events, and the optimal dosage is unclear. The objective of this study was to assess efficacy and safety of intermittent versus daily TMP/SMX for PCP prophylaxis. Methods: This systematic review included randomized controlled trials (RCTs) indexed in the Cochrane Central Register of Controlled Trials, PubMed, Ichushi, or Embase databases, published from database inception to September 2023. The inclusion criteria were adults taking intermittent or daily TMP/SMX for PCP prophylaxis. Risk of bias was assessed using the Cochrane risk-of-bias tool. The primary outcomes were PCP incidence, PCP-related mortality, and adverse events requiring temporary or permanent TMP/SMX discontinuation. Results: Four RCTs (N = 2808 patients) were included. PCP incidence did not differ significantly between the intermittent and daily regimen groups (risk ratio [RR], 1.17 [95% confidence interval {CI}, .89-1.53]; certainty: very low). There was no PCP-related mortality in the 3 RCTs reporting its outcome. Compared with the daily regimen group, the intermittent regimen group experienced significantly fewer adverse events requiring temporary or permanent TMP/SMX discontinuation (RR, 0.51 [95% CI, .42-.61]; certainty: low). Conclusions: This systematic review and meta-analysis suggests that intermittent TMP/SMX regimens for PCP prophylaxis may be more tolerable than daily regimens and may have similar efficacy. Further RCTs are needed to apply this to current practice. Clinical Trials Registration. PROSPERO (CRD42022359102).

Effects of LED lights and cytokinin on the phytotreatment of simulated swine wastewater by Azolla spp.: Pollutant removal and biomass valorization.

Phytoremediation is an eco-friendly and affordable option for tackling wastewater pollutants. The study focused on how light-emitting diodes (LED) light exposure, measured by intensity and duration (photoperiod), along with cytokinin, impacts Azolla microphylla's simulated swine wastewater treatment performance and biomass production. Under optimal treatment conditions, high removals of COD (89.2 % to 90.8 %), N-NH4+ (72.6 % to 91.2 %), N-NO3- (84.4 % to 88.6 %), Cu (75.4 % to 86.4 %), sulfamethoxazole (77.0 % to 79.0 %), P-PO43- (54.1 % to 59.9 %) and DOC (67.4 % to 71.3 %) while Zn presented a more moderate reduction (2.0 % to 9.7 %). Biomass productivity reached up to 34.8 t ha-1 yr-1. Protein production accounted for 23 % to 27 % of dry weight, while lipids ranged from 20 % to 34 % of dry biomass. Carbohydrate content varied from 8 % to 28 % of fresh weight. Higher light intensities, with both high or low values of photoperiods, and low concentrations of cytokinin were identified as optimal conditions for removal of almost all pollutants. However, pollutant removal was impacted differently by LED light and cytokinin concentration. In treatment conditions with the shortest photoperiods (8 h), the lowest residual Cu and Zn concentrations, whereas with longer photoperiods (24 h), the lowest residual concentrations of N-NH4+ and P-PO43- concentrations were recorded. On the other hand, SMX was the only parameter in which cytokinin had a clear influence on its removal, with the lowest residual concentration observed under 8-hour photoperiods combined with the lowest tested cytokinin concentrations (0.3 mg L-1). For residual COD and N-NO3-, no discernible pattern was evident for any of the analyzed factors. Therefore, the study demonstrates the potential for treating simulated swine wastewater using Azolla microphylla, aligned with its ability to produce biomass rich in high-value compounds.

A Case of Severe Thrombocytopenia, Aseptic Meningitis, and Hepatitis Caused by Trimethoprim-Sulfamethoxazole: A Triple Threat.

Trimethoprim-sulfamethoxazole (TMP-SMX), a widely used antibiotic, is associated with both predictable dose-dependent side effects and rare, idiosyncratic adverse reactions. Here, we report the case of a previously healthy, non-G6PD-deficient, 27-year-old male who developed three idiosyncratic reactions: severe thrombocytopenia, aseptic meningitis, and hepatitis concurrently following TMP-SMX administration. The Naranjo adverse reaction probability score was 7, implying TMP-SMX as the probable cause of the clinical presentation. After a comprehensive workup to rule out alternate etiologies, we have established TMP-SMX as the culprit. Our case highlights the importance of early recognition of TMP-SMX-induced rare adverse events for appropriate management to mitigate long-term sequelae and ensure favorable patient outcomes.

Sulfamethoxazole degradation in tri-electrode microbial electrochemical systems: Metabolomic and Metagenomic insights into organic pollution effects.

Organic pollutants can alter the physicochemical properties and microbial communities of water bodies. In water contaminated with organic pollutants, the unique extracellular electron transfer mechanisms that promote sulfamethoxazole (SMX) degradation in tri-electrode microbial electrochemical systems (TE-MES) may be impacted. To simulate biodegradable organic matter contamination, glucose (GLU) was added. Metagenomics and metabolomics were used to analyze changes in microbial community structure, metabolism, and function on the electrodes. GLU addition accelerated water quality deterioration, and enhanced SMX degradation. Microbial taxa on the electrodes experienced selective enrichment. Notably, methanogens and SMX-degrading bacteria were enriched, while denitrifying bacteria and antibiotic-resistant bacteria were suppressed. Enriched metabolites were linked to 15 metabolic pathways and other functions like microbial signaling and genetics. Non-redundant genes also clustered in metabolic pathways, aligning with metabolite enrichment results. Additional pathways involved life cycle processes and protein interactions. Enzymes related to carbon metabolism, particularly glycoside hydrolases, increased significantly, indicating a shift in carbon metabolism on microbial electrodes after GLU addition. The abundance of intracellular electron transfer enzymes rose, while outer membrane proteins decreased. This contrasts with the typical TE-MES mechanism where outer membrane proteins facilitate SMX degradation. The presence of organic pollution may shift SMX degradation from an extracellular electrochemical process to an intracellular metabolic process, possibly involving co-metabolism with simple organic compounds. This study provides mechanistic insights and theoretical guidance for using TE-MES with embedded microbial electrodes to treat antibiotic-contaminated water affected by organic pollution.

Sulfamethoxazole exposure shifts partial denitrification to complete denitrification: Reactor performance and microbial community.

This study elucidated the influence on a partial denitrification (PD) system under 0-1 mg/L sulfamethoxazole (SMX) stress in a sequencing batch reactor. The results showed that the nitrite accumulation rate (NAR) significantly (P ≤ 0.01) decreased from 68.68 ± 9.00% to 49.05 ± 11.68%, while the total nitrogen removal efficiency significantly (P ≤ 0.001) increased from 23.19 ± 4.42% to 31.36 ± 2.73% in presence of SMX. The results indicated that SMX exposure switched the PD process to complete denitrification through the deterioration of the nitrite accumulation and the promotion of further nitrite reduction. The SMX removal loading rate increased from 0.21 ± 0.04 to 5.03 ± 0.77 mg-SMX/(g-MLVSS·d) with the extended reactor operation under SMX stress. Low SMX concentration exposure increased extracellular polymeric substances (EPS) content from 107.69 ± 20.78 mg/g-MLVSS (0.05 mg-SMX/L) to 123.64 ± 9.66 mg/g-MLVSS (0.5 mg-SMX/L), while EPS secretion was inhibited under high SMX concentration exposure (i.e., 1 mg-SMX/L). Moreover, SMX exposure promoted the synthesis of aromatic protein-like compounds and changed the functional groups as revealed by EEM and FTIR analysis. Additionally, SMX exposure significantly shifted the microbial community structures at both phylum and genus levels. Particularly, the abundance of Thauera, i.e., functional bacteria related to PD, considerably decreased from 41.69% to 11.62% after SMX exposure, whereas the abundances of Denitratisoma and SM1A02 significantly rose under different SMX concentrations. These outcomes hinted that the addition of SMX resulted in the shifting of partial denitrification to complete denitrification.

Evaluation and analysis of the adsorption mechanism of three emerging pharmaceutical pollutants on a phosphorised carbon-based adsorbent: Application of advanced analytical models to overcome the limitation of classical models.

The double layer adsorption of sulfamethoxazole, ketoprofen and carbamazepine on a phosphorus carbon-based adsorbent was analyzed using statistical physics models. The objective of this research was to provide a physicochemical analysis of the adsorption mechanism of these organic compounds via the calculation of both steric and energetic parameters. Results showed that the adsorption mechanism of these pharmaceuticals was multimolecular where the presence of molecular aggregates (mainly dimers) could be expected in the aqueous solution. This adsorbent showed adsorption capacities at saturation from 15 to 36 mg/g for tested pharmaceutical molecules. The ketoprofen adsorption was exothermic, while the adsorption of sulfamethoxazole and carbamazepine was endothermic. The adsorption mechanism of these molecules involved physical interaction forces with interaction energies from 5.95 to 19.66 kJ/mol. These results contribute with insights on the adsorption mechanisms of pharmaceutical pollutants. The identification of molecular aggregates, the calculation of maximum adsorption capacities and the characterization of thermodynamic behavior provide crucial information for the understanding of these adsorption systems and to optimize their removal operating conditions. These findings have direct implications for wastewater treatment and environmental remediation associated with pharmaceutical pollution where advanced adsorption technologies are required.

Aquatic plants combined with microbial fuel cells promote sulfamethoxazole and sul genes removal from aquaculture pond sediments via bioelectrochemistry.

Antibiotics and antibiotic resistance genes (ARGs) in the aquaculture environment are receiving increasing public attention as emerging contaminants. In this study, aquatic plant (P) and sediment microbial fuel cells (SMFC) were used individually and in combination (P-SMFC) to simulate in situ remediation of sulfamethoxazole (SMX) and sul genes in aquaculture environments. The results showed that the average power densities of SMFC and P-SMFC were 622.18 mW m-2 and 565.99 mW m-2, respectively. The addition of 5 mg kg-1 of SMX to the sediment boosted the voltages of SMFC and P-SMFC by 36.3% and 51.5%, respectively. After 20 days of treatment, the removal efficiency of SMX from the sediment was 86.17% and 89.60% for SMFC and P-SMFC group, respectively, which were significantly higher than the control group (P < 0.05). However, removal of SMX by plants was not observed. P-SMFC group significantly reduced the biotoxicity of SMX to Staphylococcus aureus and Escherichia coli in the overlying water (P < 0.05). P and P-SMFC groups significantly reduced the abundance of ARGs intl1 and sul1 (P < 0.05). The removal rate of ARGs intl1, sul1 and sul2 from sediments by P-SMFC ranged from 94.22% to 97.08%. However, SMFC increased the abundance of sul3. SMFC and P-SMFC increased the relative abundance of some of sulfate-reducing bacteria such as Desulfatiglans, Thermodesulfovibrionia and Sva0485 in sediments. These results showed that aquatic plants promoted the removal of ARGs and SMFC promoted the removal of antibiotics, and the combination with aquatic plants and SMFC achieved a synergistic removal of both SMX and ARGs. Therefore, current study provides a promising approach for the in situ removal of antibiotics and ARGs in the aquaculture environment.