The unprecedented recent expansion in usage of paracetamol (AAP) has increased the need for suitable wastewater treatment technology. Furthermore, direct interspecies electron transfer promotion (DIET) offers simple and efficient approach for enhancing anaerobic digestion (AD). In this work, using AAP-containing domestic wastewater as feed, control AD reactor (RC) was operated, besides three DIET-promoted AD reactors (REV, RMC and REVMC, referring to electrical voltage “EV”-applied, nFe3O4-multiwall carbon nanotube (MCNT)-supplemented, and “EV applied + MCNT supplemented” reactor, respectively). Maximal treatable organic loading rates by RC, REV, RMC and REVMC were 3.9, 3.9, 7.8 and 15.6 g COD/L/d, corresponding to AAP loading rate of 26, 78, 156 and 312 μg/L/d, respectively. Methane production rate generated by RC, REV, RMC and REVMC reached 0.80 ± 0.01, 0.86 ± 0.04, 1.40 ± 0.07, and 3.01 ± 0.17 L/L/d, respectively. AAP expectedly followed hydroquinone degradation pathway, causing AD failure by acetate accumulation. However, this performance deterioration could be mitigated by DIET-promoted microbes with higher methanogenic activity and advanced electric conductivity. Economic evaluation revealed the favourability of MCNT addition over EV application, since payback periods for RC, REV, RMC and REVMC were 6.2, 7.7, 4.2 and 5.0 yr, respectively.
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