In this study the interactions between toxicity removals and Kemicetine, COD removals, intermediate products of Kemicetine and COD components (CODs originating from slowly degradable organics, readily degradable organics, inert microbial products and from the inert compounds) were investigated in a sequential anaerobic baffled reactor (ABR)/aerobic completely stirred tank reactor (CSTR) system with a real pharmaceutical wastewater. The total COD and Kemicetine removal efficiencies were 98% and 100%, respectively, in the sequential ABR/CSTR systems. 2-Amino-1 (p-nitrophenil)-1,3 propanediol, 1-p-amino phenyl, p-amino phenol and phenol were detected in the ABR as the main readily degradable inter-metabolites. In the anaerobic ABR reactor, the Kemicetin was converted to corresponding inter-metabolites and a substantial part of the COD was removed. In the aerobic CSTR reactor the intermetabolites produced in the anaerobic reactor were completely removed and the COD remaining from the anerobic reactor was biodegraded. It was found that the COD originating from the readily degradable organics did not limit the anaerobic degradation process, while the CODs originating from the slowly degradable organics and from the inert microbial products significantly decreased the anaerobic ABR reactor performance. The acute toxicity test results indicated that the toxicity decreased from the influent to the effluent of the aerobic CSTR reactor. The ANOVA test statistics showed that there was a strong linear correlation between acute toxicity, CODs originating from the slowly degradable organics and inert microbial products. A weak correlation between acute toxicity and CODs originating from the inert compounds was detected. (C) 2009 Elsevier B.V. All rights reserved.