<![CDATA[Background: Antibiotic resistance is increasingly driven by the release of antibiotic residues, antibiotic-resistant bacteria (ARB), and antibiotic resistance genes (ARGs) through wastewater. Aquatic plant-based constructed wetlands (CWs) are low-cost, nature-based treatment systems with potential to mitigate these contaminants. Objective: This narrative review evaluates the mechanisms of antibiotic, ARB, and ARG removal in planted CWs, the influence of macrophytes, substrates, and hydraulic design, and their relevance within a One Health framework. Methods: A structured search of PubMed, Scopus, and Web of Science was conducted for peer-reviewed English-language literature published from January 2014 to April 2026, supplemented by reference screening. Selected World Health Organization documents were used for policy context. No formal PRISMA process or study-level risk-of-bias assessment was undertaken. Results: Reported removal efficiencies ranged from below 30% to over 99%, depending on target contaminants, substrate, system configuration, and operating conditions. Key mechanisms included rhizosphere biodegradation, substrate adsorption, biofilm activity, plant uptake, photodegradation, and physical filtration. Reactive media such as zeolite and biochar often improved removal for selected targets, whereas evidence regarding hydraulic retention time was inconsistent. Persistence or enrichment of some ARG subtypes within substrate and biofilm compartments indicates that CWs do not consistently function as unconditional resistance sinks. Conclusion: Planted CWs are promising components of wastewater treatment for AMR mitigation, but performance remains heterogeneous. Standardized monitoring, long-term field studies, biofilm resistome characterization, hybrid treatment evaluation, and stronger One Health integration are needed.]]>
