The vermifilter (VF) is regarded as a sustainable solution for treating rural sewage. However, few studies have investigated the performance of a full-scale vermifilter. The objective of this study is to evaluate the performance of a full-scale vermifilter in reducing organic matter, nutrients, and antibiotic-resistant bacteria contained in sewage. Influent and effluents were obtained from a rural sewage treatment plant using a VF and UV disinfection system. The results show a significant removal (p < 0.05) of chemical organic demand (COD) (77%), biochemical oxygen demand (BOD5) (84%), total nitrogen (TN) (53%), and total phosphorus (36%). Seasonality is an influential variable for COD, BOD5, and TN removal. In addition, the molecular weight distribution shows that the VF does not generate a considerable change in the distribution of organic matter (COD and total organic carbon (TOC)) and NH4+-N. The UV disinfection system eliminated 99% of coliform bacteria; however, they are not eliminated to safe concentrations. Therefore, it is possible to detect bacteria resistant to the antibiotics ciprofloxacin, amoxicillin, and ceftriaxone at 63.5%, 87.3%, and 63.5%, respectively, which were detected in the effluents. This study shows the potential of a system for the removal of pollution and the need to optimize the VF to be a safe treatment.

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