Antibiotic Resistance and Sanitation in India: Current Situation and Future Perspectives
Antimicrobial resistance (AMR) is a global threat as the existing health care may become ineffective. Antibiotics, antibiotic-resistant bacteria (ARB), and antibiotic resistance genes (ARGs) considered as emerging contaminants are the three major componen
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Contents 1 Introduction 2 Antibiotic Consumption for Therapeutics Purpose 3 Antibiotics Use in the Animal Food Industry 4 Source and Pathways of Antibiotics, ARB, and ARGs in the Environment 5 Antibiotics in Different Environmental Matrices 6 Seasonal and Spatial Variation of Antibiotics in the Environment Matrices 7 Antibiotic-Resistant Bacteria in the Environment 8 Antibiotic Resistance Genes in the Environment 9 Indian WWTPs Status in Eliminating Antibiotics, ARB, and ARG 10 India’s Action Plans on AMR and Current Status 11 Conclusion References
Abstract Antimicrobial resistance (AMR) is a global threat as the existing health care may become ineffective. Antibiotics, antibiotic-resistant bacteria (ARB), and antibiotic resistance genes (ARGs) considered as emerging contaminants are the three major components of AMR. India is one of the largest consumers of antibiotics with defined daily dose (DDD) of 4,950 per 1,000 population in 2015. By 2030, therapeutic and nontherapeutic use of antibiotics in veterinary animals is projected to increase by 18%. Antibiotics, ARB, and ARGs in the solid and liquid waste generated enter the environment via different pathways. The major sources of antibiotics, ARB, and ARG include domestic, hospital, and pharmaceutical industry wastewater apart from the solid/liquid waste generated from veterinary and food animals. Existing conventional wastewater treatment technologies like activated
R. Sasikaladevi, V. Kiruthika Eswari, and I. M. Nambi (*) Environmental and Water Resource Engineering Division, Department of Civil Engineering, IIT Madras, Chennai, India e-mail: [email protected] Celia M. Manaia, Erica Donner, Ivone Vaz-Moreira, and Peiying Hong (eds.), Antibiotic Resistance in the Environment: A Worldwide Overview, Hdb Env Chem, DOI 10.1007/698_2020_608, © Springer Nature Switzerland AG 2020
R. Sasikaladevi et al.
sludge process (ASP) do not ensure complete removal of antibiotics, ARB, and ARGs from wastewater. Similarly, the sludge generated find its way to agriculture land and eventually spread resistance in the environment. Once introduced in the environment, elimination of these contaminants is difficult. India’s action plan on AMR in 2017 regulates antibiotic use for human and animal and addresses environment AMR spread from all possible sources and containment. In 2020, the Government of India introduced discharge standard for 121 antibiotics in the effluents of bulk drug manufacturing industries, formulation industries, and common effluent treatment plant (CETP) receiving pharmaceutical wastewater. Keywords AMR, Antibiotics, ARB, ARG, Discharge standards, Environment, India, Nontherapeutic, Solid and liquid waste, Therapeutic, Wastewater treatment
1 Introduction Antibiotic resistance is a major public health concern at the global level as the existing health-care services may become ineffective. To exemplify, chloramphenicol is no longer a preferred choice for treating patients with antibiotic-resistant bacterial infections [1]. By 2050, two million deaths are projected
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