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Int. J. Environ. Res. Public Health 2016, 13(6), 588; doi:10.3390/ijerph13060588

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

1
Global Health—Health Systems and Policy (HSP), Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18 A, Stockholm 17177, Sweden
2
Department of Pharmaceutical Management and Pharmaco-Economics, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hoan Kiem District, Hanoi, Vietnam
3
Department of Pharmacy, National Cancer Hospital, 30 Cau Buou, Thanh Tri District, Hanoi, Vietnam
4
Department of Family Medicine, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi, Vietnam
5
Institute of Mathematics-VAST, 18 Hoang Quoc Viet, Cau Giay District, Hanoi, Vietnam
6
Department of Public Health & Environment, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India
7
Hanoi Drug and Cosmetic Testing Centre, 7/107 Nguyen Chi Thanh, Dong Da district, Hanoi, Vietnam
8
Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 16 April 2016 / Revised: 30 May 2016 / Accepted: 7 June 2016 / Published: 14 June 2016
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Abstract

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). View Full-Text
Keywords: antibiotic residues; hospital wastewater; ciprofloxacin; metronidazole antibiotic residues; hospital wastewater; ciprofloxacin; metronidazole
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Lien, L.T.Q.; Hoa, N.Q.; Chuc, N.T.K.; Thoa, N.T.M.; Phuc, H.D.; Diwan, V.; Dat, N.T.; Tamhankar, A.J.; Lundborg, C.S. 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. Int. J. Environ. Res. Public Health 2016, 13, 588.

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