Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use-A One Year Study from Vietnam.
Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital's wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital's wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001).
Global Health-Health Systems and Policy (HSP), Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, Tomtebodav&#228;gen 18 A, Stockholm 17177, Sweden. lienlathiquynhki@gmail.com.|Department of Pharmaceutical Management and Pharmaco-Economics, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hoan Kiem District, Hanoi, Vietnam. lienlathiquynhki@gmail.com.
La Thi Quynh
LT
Lien
Department of Pharmacy, National Cancer Hospital, 30 Cau Buou, Thanh Tri District, Hanoi, Vietnam. quynhhoa29@gmail.com.
Nguyen Quynh
NQ
Hoa
Department of Family Medicine, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi, Vietnam. ntkchuc@yahoo.com.
Nguyen Thi Kim
NT
Chuc
Department of Family Medicine, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi, Vietnam. ntmthoa@gmail.com.
Nguyen Thi Minh
NT
Thoa
Institute of Mathematics-VAST, 18 Hoang Quoc Viet, Cau Giay District, Hanoi, Vietnam. hodang54@yahoo.com.
Ho Dang
HD
Phuc
Global Health-Health Systems and Policy (HSP), Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, Tomtebodav&#228;gen 18 A, Stockholm 17177, Sweden. vishaldiwan@hotmail.com.|Department of Public Health &amp; Environment, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India. vishaldiwan@hotmail.com.
Vishal
V
Diwan
Hanoi Drug and Cosmetic Testing Centre, 7/107 Nguyen Chi Thanh, Dong Da district, Hanoi, Vietnam. cnlname@yahoo.com.
Nguyen Thanh
NT
Dat
Global Health-Health Systems and Policy (HSP), Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, Tomtebodav&#228;gen 18 A, Stockholm 17177, Sweden. ejetee@gmail.com.|Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India. ejetee@gmail.com.
Ashok J
AJ
Tamhankar
Global Health-Health Systems and Policy (HSP), Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, Tomtebodav&#228;gen 18 A, Stockholm 17177, Sweden. Cecilia.Stalsby.Lundborg@ki.se.
Cecilia Stålsby
CS
Lundborg
D000900:Anti-Bacterial Agents / Q000032:analysis*; D002939:Ciprofloxacin / Q000032:analysis; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004784:Environmental Monitoring; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008795:Metronidazole / Q000032:analysis; D052616:Solid Phase Extraction; D014744:Vietnam; D014865:Waste Disposal, Fluid / Q000379:methods; D062065:Wastewater / Q000032:analysis; D014874:Water Pollutants, Chemical / Q000032:analysis*
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D008795:Metronidazole; D062065:Wastewater; D014874:Water Pollutants, Chemical
antibiotic residues; ciprofloxacin; hospital wastewater; metronidazole