Assessing the concentrations and risks of toxicity from the antibiotics ciprofloxacin, sulfamethoxazole, trimethoprim and erythromycin in European rivers

This study evaluated the potential concentrations of four antibiotics: ciprofloxacin (CIP), sulfamethoxazole (SUF), trimethoprim (TRI) and erythromycin (ERY) throughout the rivers of Europe. This involved reviewing national consumption rates together with assessing excretion and sewage treatment removal rates. From this information, it was possible to construct best, expected and worst case scenarios for the discharge of these antibiotics into rivers. Consumption data showed surprising variations, up to 200-fold in the popularity of different antibiotics across different European nations. Using the water resources model GWAVA which has a spatial resolution of approximately 6 × 9 km, river water concentrations throughout Europe were predicted based on 31-year climate data. The modelled antibiotic concentrations were within the range of measurements reported previously in European effluents and rivers. With the expected scenario, the predicted annual-average antibiotic concentrations ranged between 0 and 10 ng/L for 90% by length of surface waters. In the worst case scenario concentrations could reach between 0.1 and 1 μg/L at the most exposed locations. As both predicted and observed sewage effluent concentrations were below reported effect levels for the most sensitive aquatic wildlife, no direct toxicity in rivers is expected. Predicted river concentrations for CIP and ERY were closest to effect levels in wildlife, followed by SUF which was 2–3 orders of magnitude lower. TRI appeared to be of the least concern with around 6 orders of magnitude difference between predicted and effect levels. However, mixture toxicity may elevate this risk and antibiotic levels of 0.1–1 μg/L in hotspots may contribute to local environmental antibiotic resistance in microorganisms