Previous research has established a MES embedding a microbial electrode to facilitate the degradation of antibiotics in water. We modified microbial electrodes in the MES with PEDOT and rGO to enhance electron utilization on electrodes and to further promote antibiotic degradation. Density functional theory calculations on the SMX molecule indicated that the C4-S8 and S8-N27 bonds are the most susceptible to electron attack. The introduction of various functional groups and multivalent elements enhanced the electrodes' capacitance and electron mediation capabilities. This led to enhance both electron utilization on the electrodes and the removal efficiency of SMX. After 120 hours, the degradation efficiency of SMX by PEDOT and rGO-modified electrodes increased by 45.47% and 25.19%, respectively, compared to unmodified electrodes. The relative abundance of sulfate-reducing and denitrifying bacteria significantly increased in PEDOT and rGO-modified electrodes, while the abundance of nitrifying bacteria and potential antibiotic resistance gene host microbes significantly decreased. The impact of PEDOT modification positively influenced microbial Cellular Processes, including cell growth, death, and motility. This study provides insights into the mechanisms of direct electron involvement in antibiotic degradation steps in microbial electrochemistry, and provides a possible path for improved strategies in antibiotic degradation and sustainable environmental remediation.