Pharmaceuticals and personal care products (PPCPs) constitute a class of newly discovered micropollutants that harm living aquatic organisms. Pharmaceutical drugs, such as antibiotics, are commonly found in freshwater ecosystems and wastewater treatment effluents. Notably, antibiotics can enter freshwater habitats, posing a growing ecological threat. Additionally, PPCPs are hazardous to aquatic organisms both acutely and chronically. This study focused on peer-reviewed articles on PPCPs from 2000 to 2025 on scholarly databases. The initial literature search yielded 1,760 articles. After removing duplicates and systematically assessing study relevance, the dataset was narrowed to 1,172 articles. VOSviewer software was used to generate visual maps of keyword relatedness. We evaluated the quantitative concentrations (ng/L to µg/L) of antibiotics and PCP and reviewed their effects on growth, development, and reproductive functions in aquatic organisms. Importantly, research has uncovered a link between antibiotics and PCP pollution, which affects aquatic life. The elimination of antibiotics and PCPs has been achieved through various degrading techniques, including chemical and biological processes. However, antibiotics and PCPs cannot be entirely eliminated through biological and chemical treatments. Therefore, more effective, environmentally friendly methods must be developed for treating antibiotics and PCPs in aqueous media. This article thoroughly reviews the presence, fate, and possible hazards of antibiotics and PCPs in freshwater organisms. Additionally, this review article addresses the current knowledge gap regarding the levels and trends of antibiotics and PCPs in freshwater environments. Finally, it provides suggestions and innovative strategies that can help manage and evaluate ecological risks and contamination levels for further study.
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