Aquatic environmental risk assessment for human use of the old antibiotic sulfamethoxazole in Europe

Abstract

Sulfamethoxazole (SMX) is an old sulfonamide antibiotic that was launched first in combination with trimethoprim in 1969 by F.Hoffmann-La Roche. Although sales figures for SMX have been declining over the past 20 yr, the compound is still widely used; moreover, many measured environmental concentrations (MECs) are available from Europe, the United States, Asia, Australia, and Africa. To assess aquatic risks of SMX in Europe, the exposure of European surface waters was predicted based on actual sales figures from IMS Health, incorporating environmental fate data on one side, and based on collated MECs representing more than 5500 single measurements in Europe on the other. Environmental effects were assessed using chronic and subchronic ecotoxicity data for 16 groups of aquatic organisms, from periphyton communities to cyanobacteria, algae, higher plants, various invertebrates, and vertebrates. Predicted no-effect concentrations (PNECs) were derived using both deterministic and probabilistic methodology.

Pharmaceuticals in the environment: An introduction to the ET&C special issue

“…Elucidating the role of environmental processes for causing antimicrobial resistance might also warrant increased attention in the future, particularly because antibiotics are commonly detected in various ecosystems. For example, sulfamethoxazole is ubiquitous in aquatic urban environments throughout the United States, confirming previous studies , but its impact on antimicrobial resistance is largely unknown . So far, SETAC as a society has not been engaged much in research on antimicrobial resistance, but our members' collective skills in environmental chemistry, ecotoxicology, and environmental sciences make us well placed to provide important contributions to this critical global issue in the future.…”

Environmental impact and biological removal processes of pharmaceutically active compounds: The particular case of sulfonamides, anticonvulsants and steroid estrogens

“…Although no SMX effects alone have been thoroughly reported, Pomati et al (2006) refer to the inhibition of human embryonic kidney cells at concentrations of nanograms per liter for a mixture of antibiotics containing sulfamethoxazole. On the other hand, Straub (2016) stated that no risk is apparent for indirect human exposure to SMX through drinking water and food, whereas Uslu, Jasim, Arvai, Bewtra, and Biswas (2013) came to the same conclusion regarding water bodies. However, this is not the case for sulfamethazine, which has the potential to increase thyroid gland follicular adenoma (Leung et al, 2013).…”

“…SMX, CBZ, E2 and EE2 in different environmental compartments (Ting & Praveena, 2017). (Straub, 2016). However, the toxicity values of PhACs reported in the literature should be carefully analyzed since the results are strongly dependent on the species involved, and whether in vitro or in vivo assays are used (Laurenson et al, 2014).…”

Monitoring occurrence and removal of selected pharmaceuticals in two different wastewater treatment plants

“…Of the antimicrobials investigated, negative (increase in concentration after final treatment) or no removal of SMZ was observed in both the plants; instead, a higher concentration of SMZ was observed in the final treated effluent (+ 36% in WWTP1 and + 71% in WWTP2). Straub [29] reported that rapid absorption and metabolism of SMZ leads to the formation N4-acetyl-SMZ (NAcSMZ) and glucuronide conjugates (GluSMZ) which subsequently converts back to the parent form leading to net negative removal in the wastewater treatment plant. Furthermore, biodegradation studies conducted by Richardson and Bowron [30] indicated that both ERY and SMZ are non-biodegradable by the wastewater treatment processes.…”