Environment and Antimicrobial Resistance


Starter Questions:

Are there antibiotics in our waterways? How did they get there?

Should we be worried about herbicides and antibiotics mixing in the environment?

What are the potential effects of microplastics on antimicrobial resistance?

Could antibiotics be contributing to climate change?

Pharmaceutical companies found to lack transparency and accountability in antibiotic pollution

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As a part of the HCWH Europe’s Safer Pharma campaign, one recent study finds that pharmaceutical companies around the world are lacking in accountability and transparency regarding antibiotic pollution, failing to regularly release data concerning environmental sustainability and governance. This is problematic, as various reports show that a number of pharmaceutical companies pollute the environment with antibiotics through wastewater from production plants. In this regard, increased transparency could set a precedent, encouraging responsible future practices, while possibly driving technology investments. As a result, the study concludes, albeit caveated with small sample sizes and limited information, that all stakeholders, including governmental organizations and intergovernmental groups, must push for legislation and policies that call for not only greater accountability and transparency regarding antibiotic pollution. While such policies and legislation have been proposed in the past, these examples, such as the Strategic Approach to Pharmaceuticals in the Environment from the EU, are now three years overdue, and still awaiting finalization.

Source: Healthcare Without Harm

CDC puts forth initiatives for addressing AMR in the environment

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The CDC, in collaboration with the United Kingdom Science and Innovation Network and the Wellcome Trust, published Initiatives for Addressing Antimicrobial Resistance in the Environment (Executive Summary and Current Situations and Challenges), which gives an overview of the evidence base and knowledge gaps around the connections among antibiotic resistance, the environment and the impact on human health. The report highlights that antimicrobials and antimicrobial-resistant microbes are present and spread through the environment, such as through waterways and soil, as the result of human activity. For example, human, animal and pharmaceutical manufacturing waste, as well as the use of antimicrobial pesticides for crops, can contaminate the environment, yet the scale and risk for human health of such contamination is not well understood. A few of the proposed initiatives include the improvement of hospital waste management strategies based on evidence-based standards globally; the promotion of good hygiene and sanitation to mitigate antibiotic pollution from human waste and wastewater contamination; the lowering of antimicrobial use in animals through the implementation of alternative disease control strategies and better animal husbandry practices; the establishment of discharge limits and monitoring and reporting standards for antimicrobial manufacturing sites; and improved transparency surrounding the use of antimicrobials as pesticides. Overall, the report suggests that activities addressing AMR in the environment be aligned with ongoing global public health efforts (i.e. the Sustainable Development Goals, the Water, Sanitation and Hygiene Initiative, and the Global Health Security Agenda).

Source: Centers for Disease Control and Prevention

US PIRG and civil society groups receive more than 45,000 signatures petitioning the EPA to disallow spraying of antibiotics on citrus

In order to combat citrus greening, the EPA has cleared the use of nearly 440,000 kilograms (650,000 pounds) of streptomycin and oxytetracycline as “routine treatments.” Citrus greening is a bacterial disease carried by the Asian citrus psyllid that threatens a $10 billion+ industry and more than a fifth of Florida citrus crops in 2017. In response, advocates from public health and environmental groups around the world have garnered more than 45,000 signatures on a petition asking the EPA to deny this use of antibiotics. Because streptomycin is considered “critically important” to human health by the World Health Organization, meaning that it serves as a last line of defense to treat multidrug resistant bacteria, less than 14,000 pounds are used in America each year. The current citrus field proposal, constituting the largest use of medically important antibiotics in plant agriculture, has been condemned by public health officials and environmental groups alike. Matt Wellington from US PIRG explains: “the potential problems created by spraying massive amounts of streptomycin on citrus fields would outweigh the original problem the EPA wants to solve.” Indeed, spraying antibiotics on citrus plants does not guarantee the prevention of the disease, and does nothing to cure plants already affected by the disease, it solely helps the plant survive for a longer period of time. With R&D for various alternatives to the use of antibiotics such as genetic engineering continues, policymakers urge the EPA to stand firm against the use of excessive antibiotics. As EPA policy specialist Emily Knobbe concludes, “spraying orange and grapefruit trees with an antibiotic we use to treat human disease is a dangerously short-sighted idea.” In addition to perpetuating antibiotic resistance, this proposal could harm surrounding Florida wildlife and nearby foraging mammals.

Source: US PIRG

Keep Antibiotics Working opposes the EPA’s approval of streptomycin use on citrus crops

Keep Antibiotics Working (KAW) sent a letter to the U.S. Environmental Protection Agency (EPA) to oppose the agency’s decision to approve the use of the antibiotic streptomycin for citrus greening disease. They argue that such an approval would lead to huge increases in the use of this medically important antibiotic in agriculture, resulting in the quantity of streptomycin used on citrus crops vastly exceeding the quantity used in human medicine. KAW’s analysis indicates that if citrus growers abide by the maximum annual rate allowed in the EPA proposal (1.02 lbs of streptomycin per acre), they are expected to use 35,3475 kg of streptomycin per year, which is 22 times more than on any other crop, 1.4 times more than the quantity sold for use in animals, and 54 times more than the 6,485 kg of aminoglycosides (the antibiotic family encompassing streptomycin) used in human medicine.
Not only this, but crops would receive the active ingredient multiple times a year, as it suppresses rather than treats the disease, without any possibility of testing for resistance development, as the target pathogen cannot be grown in culture. KAW emphasizes that these practices run contrary to the principles of antimicrobial stewardship. In addition, the letter argues that the EPA should consider the risk such routine streptomycin use poses to microbial ecosystems and animal and plant health, ensure it does not jeopardize any endangered species, mitigate any risks posed to workers exposed to streptomycin, and redo the antimicrobial resistance risk assessment accounting for its potential risks posed to consumers.

Source: Keep Antibiotics Working