Antibiotics, their transformation products, and the translocation of antibiotic-resistant genes in the environment pose significant health risks to humans, animals, and ecosystems, aligning with the One Health concept. Constructed wetlands hold substantial yet underutilized potential for treating wastewater from agricultural, domestic sewage, or contaminated effluents from wastewater treatment plants, with the goal of eliminating antibiotics.

However, the comprehensive understanding of the distribution, persistence, and dissipation processes of antibiotics within constructed wetlands remains largely unexplored. In this context, we provide an overview of the current application of stable isotope analysis at natural abundance to antibiotics. We explore the opportunities of an advanced multiple stable isotope approach, where isotope concepts could be effectively applied to examine the fate of antibiotics in wetlands. The development of a conceptual framework to study antibiotics in wetlands using multi-element stable isotopes introduces a new paradigm, offering enhanced insights into the identification and quantification of natural attenuation of antibiotics within wetland systems. This perspective has the potential to inspire the general public, governmental bodies, and the broader research community, fostering an emphasis on the utilization of stable isotope analysis for studying antibiotics and other emerging micropollutants in wetland systems.