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Temporal variability of antibiotics fluxes in wastewater and contribution from hospitals.

Coutu S, Rossi L, Barry DA, Rudaz S, Vernaz N - PLoS ONE (2013)

Bottom Line: Source variability (i.e., antibiotic consumption, monthly data for 2006-2010) were examined in detail for nine antibiotics--azithromycin, ciprofloxacin, clarithromycin, clindamycin, metronidazole, norfloxacin, ofloxacin, sulfamethoxazole and trimethoprim, from which two main conclusions were reached.This seasonality in consumption resulted in seasonality in Predicted Environmental Concentrations (PECs).Second, the contribution of hospitals to the total load of antibiotics reaching the Lausanne Wastewater Treatment Plant (WTP) fluctuated markedly on a monthly time scale, but with no seasonal pattern detected.

View Article: PubMed Central - PubMed

Affiliation: ENAC/IIE/ECOL, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland. sylvain.coutu@epfl.ch

ABSTRACT
Significant quantities of antibiotics are used in all parts of the globe to treat diseases with bacterial origins. After ingestion, antibiotics are excreted by the patient and transmitted in due course to the aquatic environment. This study examined temporal fluctuations (monthly time scale) in antibiotic sources (ambulatory sales and data from a hospital dispensary) for Lausanne, Switzerland. Source variability (i.e., antibiotic consumption, monthly data for 2006-2010) were examined in detail for nine antibiotics--azithromycin, ciprofloxacin, clarithromycin, clindamycin, metronidazole, norfloxacin, ofloxacin, sulfamethoxazole and trimethoprim, from which two main conclusions were reached. First, some substances--azithromycin, clarithromycin, ciprofloxacin--displayed high seasonality in their consumption, with the winter peak being up to three times higher than the summer minimum. This seasonality in consumption resulted in seasonality in Predicted Environmental Concentrations (PECs). In addition, the seasonality in PECs was also influenced by that in the base wastewater flow. Second, the contribution of hospitals to the total load of antibiotics reaching the Lausanne Wastewater Treatment Plant (WTP) fluctuated markedly on a monthly time scale, but with no seasonal pattern detected. That is, there was no connection between fluctuations in ambulatory and hospital consumption for the substances investigated.

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Related in: MedlinePlus

Annual antibiotics sales estimated for the city of Lausanne.Blue: ambulatory sales, red: total sales. From one year to the next, the contribution of hospitals to the total load of antibiotics consumed varies little. Likewise, ambulatory sales show little variation.
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pone-0053592-g003: Annual antibiotics sales estimated for the city of Lausanne.Blue: ambulatory sales, red: total sales. From one year to the next, the contribution of hospitals to the total load of antibiotics consumed varies little. Likewise, ambulatory sales show little variation.

Mentions: In Eq.1, the CHUV consumption, , is normalized by the number of CHUV beds, (), and then multiplied by the total number of hospital beds in the WTP catchment, (). This estimation integrates indirectly the occupation rate of hospital beds, which is assumed to be identical for all hospitals. Only hospitals with acute somatic treatments were considered as they are likely to prescribe antibiotics. CHUV data covered the same period as the ambulatory antibiotics sales data. Description of antibiotics sales datasets and data processing performed are summarized in Table 1. Yearly total amounts of antibiotics used in the ambulatory and hospital domains are summarized in Figure 3.


Temporal variability of antibiotics fluxes in wastewater and contribution from hospitals.

Coutu S, Rossi L, Barry DA, Rudaz S, Vernaz N - PLoS ONE (2013)

Annual antibiotics sales estimated for the city of Lausanne.Blue: ambulatory sales, red: total sales. From one year to the next, the contribution of hospitals to the total load of antibiotics consumed varies little. Likewise, ambulatory sales show little variation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539968&req=5

pone-0053592-g003: Annual antibiotics sales estimated for the city of Lausanne.Blue: ambulatory sales, red: total sales. From one year to the next, the contribution of hospitals to the total load of antibiotics consumed varies little. Likewise, ambulatory sales show little variation.
Mentions: In Eq.1, the CHUV consumption, , is normalized by the number of CHUV beds, (), and then multiplied by the total number of hospital beds in the WTP catchment, (). This estimation integrates indirectly the occupation rate of hospital beds, which is assumed to be identical for all hospitals. Only hospitals with acute somatic treatments were considered as they are likely to prescribe antibiotics. CHUV data covered the same period as the ambulatory antibiotics sales data. Description of antibiotics sales datasets and data processing performed are summarized in Table 1. Yearly total amounts of antibiotics used in the ambulatory and hospital domains are summarized in Figure 3.

Bottom Line: Source variability (i.e., antibiotic consumption, monthly data for 2006-2010) were examined in detail for nine antibiotics--azithromycin, ciprofloxacin, clarithromycin, clindamycin, metronidazole, norfloxacin, ofloxacin, sulfamethoxazole and trimethoprim, from which two main conclusions were reached.This seasonality in consumption resulted in seasonality in Predicted Environmental Concentrations (PECs).Second, the contribution of hospitals to the total load of antibiotics reaching the Lausanne Wastewater Treatment Plant (WTP) fluctuated markedly on a monthly time scale, but with no seasonal pattern detected.

View Article: PubMed Central - PubMed

Affiliation: ENAC/IIE/ECOL, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland. sylvain.coutu@epfl.ch

ABSTRACT
Significant quantities of antibiotics are used in all parts of the globe to treat diseases with bacterial origins. After ingestion, antibiotics are excreted by the patient and transmitted in due course to the aquatic environment. This study examined temporal fluctuations (monthly time scale) in antibiotic sources (ambulatory sales and data from a hospital dispensary) for Lausanne, Switzerland. Source variability (i.e., antibiotic consumption, monthly data for 2006-2010) were examined in detail for nine antibiotics--azithromycin, ciprofloxacin, clarithromycin, clindamycin, metronidazole, norfloxacin, ofloxacin, sulfamethoxazole and trimethoprim, from which two main conclusions were reached. First, some substances--azithromycin, clarithromycin, ciprofloxacin--displayed high seasonality in their consumption, with the winter peak being up to three times higher than the summer minimum. This seasonality in consumption resulted in seasonality in Predicted Environmental Concentrations (PECs). In addition, the seasonality in PECs was also influenced by that in the base wastewater flow. Second, the contribution of hospitals to the total load of antibiotics reaching the Lausanne Wastewater Treatment Plant (WTP) fluctuated markedly on a monthly time scale, but with no seasonal pattern detected. That is, there was no connection between fluctuations in ambulatory and hospital consumption for the substances investigated.

Show MeSH
Related in: MedlinePlus