Increased antibiotic use worldwide has become a major concern because of their health and environmental impacts. Since most antibiotic residues can hardly be removed from wastewater using conventional treatments, alternative methods receive great attention. Adsorption is one of the most efficient and cost-effective treatment methods for antibiotics. Among the adsorbents, clay minerals have garnered increasing attention due to their unique properties including availability, high specific surface area, low cost, cation exchange capacity, and good removal efficiency. This paper reviews the recent progress made in the use of natural and modified clay minerals for the removal of antibiotics from water. First, the sources, occurrence, removal and health effects of the antibiotics commonly encountered in water bodies are described. Antibiotic concentration levels and average removal efficiencies measured in conventional activated sludge treatment systems worldwide are also provided to better address the problem. Second, the review explores the characteristics of clay minerals as adsorbent of antibiotics and the factors affecting the adsorption. The review identifies and discusses the future trends and strategies used to increase the adsorption capacity of clay minerals by modification and combination techniques (intercalation of novel functional groups such as organocations, biopolymers and metal pillared-clay minerals, combination with biochar or thermal activation). The quantitative comparisons of clay minerals' ability for antibiotic removal are given. Some natural clay minerals have good removal potential for antibiotics, with maximum adsorption capacities over 100mg/g. For most other adsorbents, surface modifications and combination techniques resulted in improved adsorption properties (including higher surface area, enhanced adsorption capacity, increased stability and mechanical strength). Finally, the application of these adsorbents at pilot scale, using real wastewater samples, their reuse, economic analysis and life cycle assessment are other issues that have been considered.
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