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Aquatic systems, particularly in rural areas, may be contaminated by antimicrobials from wastewater treatment effluent or diffuse pollution. Recent investigations of pharmaceutical contaminants in surface waters in the United States and Europe revealed the presence of antimicrobials such as synthetic and naturally derived antibiotics used in human and veterinary medicine. The fate of these antimicrobials in the aquatic environment, along with the rising trend of antibacterial resistance in aquatic and soil microorganisms, is poorly understood. This research was designed to investigate the removal of antimicrobials in multistage filtration, provide information for rural communities affected by antimicrobial surface water pollution, identify topics for future research, and aid environmental and human health risk assessments. The study examined schmutzdecke sorption behavior and removal efficiencies in a pilot roughing and slow sand filter fed 0.2 mg/L of five compounds from four classes of antimicrobials. Aqueous antimicrobial concentrations were analyzed by high-performance liquid chromatography/tandem mass spectrometry. Includes 39 references, tables, figures.