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The increasing use of antibiotics by humans and their persistence in the environment leads to the development of drug resistance, which is nowadays considered as an environmental problem. The aim of this study was to determine the efficacy of sono-electro-Fenton process for removal of Cefixime antibiotic from aqueous solutions by Response Surface Methodology (RSM) and to evaluate the toxicity of effluent by microorganisms. In the present study, the degradation of synthetic wastewater containing Cefixime was investigated in a reactor (with a useful volume of 1 L) located in the chamber of the ultrasonic device. The effects of pH, hydrogen peroxide concentration, voltage, initial antibiotic concentration, and electrolysis time were investigated using the Box-Behnken model, and the optimal conditions for elimination were obtained by analyzing the variance. The performance of the electro-Fenton and ultrasonic …