Antibiotic Residues in Waste Water of Rural and Urban Hospitals from South India

Radhakrishna Lagishetty *

Department of Pharmacology, Vishnu Dental College, Vishnupur, Bhimavaram, Andhra Pradesh-534202, India.

Prabhu Saran Nagarajan

Trichy SRM Medical College Hospital and Research Centre, Irungalur, Trichy, Tamil Nadu-621105, India.

*Author to whom correspondence should be addressed.


Hospital effluent acts as the store house of pharmaceutical residues, harmful infectious agents such as the pathogens and microorganisms possessing multiple drug resistant genes. The antibiotics detected in hospitals have been shown to possibly exert effects on bacteria that lead to increased resistance. Present study was chosen to quantify the antibiotic residues in water associated with hospitals in South India. The samples were analyzed using high performance liquid chromatography (HPLC). A total of ten samples were analyzed. A total of 45 different antibiotics were identified and quantified among 10 hospital effluents. The quantification was given in method detection quantification limit (MDQL) and in trace. Among all the ten samples the maximum MDQL was detected as 17834 ng/ L (trimethoprim). Out of the gallery of antibiotics detected in this study, four antibiotics supported MDQL with more than 10000 ng/ L. The lowest trace value of antibiotic with 46 ng/ L (gatifloxacin) and maximum of 896 ng/ L (cefipime) was detected in sample 10 and 5 respectively. Hospitals and its effluents are one of the high sources for discharge of antibiotics and multidrug resistant strains into the environment and proportionallyexert a serious public health threat through confining the antibiotic pool. Likewise studies are required to figure out the presence of antibiotics in aquatic environment and the development of antimicrobial resistance and its subsequent public health impact.

Keywords: Antibiotics, hospital effluents, HPLC, antibiotic resistance

How to Cite

Lagishetty, R., & Nagarajan, P. S. (2023). Antibiotic Residues in Waste Water of Rural and Urban Hospitals from South India. UTTAR PRADESH JOURNAL OF ZOOLOGY, 44(3), 26–37.


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Eili YK, Thomas P, Van B, Elena MM, Suraj P, Sumanth G, Simon AL, Herman G, Ramanan L. Global increase and geographic convergence in antibiotic consumption between 200 and 2015. Proc Natl Acad Sci USA. 2018;115: 3463- 70.

Patel M, Kumar R, Kishor K, Todd M, Charles U, Pittman Jr, Dinesh Mohan. Pharmaceuticals of emerging concern in aquatic systems: Chemistry, occurrence, effects, and removal methods. Chem Rev. 2019;119: 3510–673.

Singh AK, Kaur R, Verma S, Singh S. Antimicrobials and antibiotic resistance genes in water bodies: pollution, risk, and control. Front Environ Sci. 2022;10:830- 61.

Lulijwa R, Rupia EJ, Alfaro AC. Antibiotic use in aquaculture, policies and regulation, health and environmental risks: a review of the top 15 major producers. Rev Aquac. 2020;12:640–63.

Sun R, Chen J, Pan C. Antibiotics and food safety in aquaculture. J Agric Food Chem 2020: 68: 11908–919.

Okeke, ES, Chukwudozie KI, Nyaruaba. Antibiotic resistance in aquaculture and aquatic organisms: A review of current nanotechnology applications for sustainable management. Environ Sci Pollut Res 2022;29: 69241–274.

Liu C, Tan L, Zhang L et al. A review of the distribution of antibiotics in water in different regions of china and current antibiotic degradation pathways. Front Environ Sci. 2021;9:1–24.

Larsson, DGJ, Flach, CF. Antibiotic resistance in the environment. Nat Rev Microbiol. 2022;20: 257–269.

Vishal D, Ashok J, Tamhankar, ManjeetAggarwal, ShantaSen, Rakesh K. Khandal and Cecilia Stålsby L. Detection of antibiotics in hospital effluents in India. CURR SCI. 2009;97:1752-1755.

Kummerer K. Antibiotics in the aquatic environment- a review- Part II. Chemosph. 2009;75: 417-434.

Kim DW, Cha CJ. Antibiotic resistome from the One-Health perspective: Understanding and controlling antimicrobial resistance transmission. Exp Mol Med. 2021;53:301–09.

Diwan V, Tamhankar AJ, Khandal RK, Sen S, Aggarwal M, Marothi Y, Iyer RV, Sundblad-Tonderski K, Stalsby-Lundborg C. Antibiotics and antibiotic resistant bacteria in waters associated with a hospital in Ujjain, India. BMC PublHlth. 2010;10:414-419.

Manisha S, Kapil K, Kashyap Kumar D. Disposal of unused antibiotics as household waste: A social driver of antimicrobial resistance. Envnt Qual Mang. 2021;30:127-140.

Loumame Eh, Tounsi A, Amir S, Soraa N, Ouazzani N. Microbial Resistance to Carbapenems in Effluents from Gynaecological, Paediatric and Surgical Hospital Units. Antibiotics 2022;11: 1103.

Nasri E, Subirats J, Sànchez-Melsió A, Ben Mansour HC, Borrego M, Balcázar JL. Abundance of carbapenemase genes (blaKPC, blaNDM and blaOXA-48) in wastewater effluents from Tunisian hospitals. Environ. Pollut. 2017;229: 371–74.

Sharma DR, Pradhan B, Mishra SK. Multiple drug resistance in bacterial isolates from liquid wastes generated in central hospitals of Nepal. Kathmandu University Med J 2010: 8: 40-44.

Tsai CT, Lai JS, Lin ST. Quantification of pathogenic microorganisms in the sludge from treated hospital waste water. J ApplMicrobiol. 1998;85:171-176.

Heberer T. Occurrence, fate, and removal of pharmaceutical residues in the aquatic environment: a review of recent research data. Toxicol Lett. 2002;131:5-17.

Thai PK, Binh VN, Nhung PH, Nhan PT, Hieu NQ, Dang NT, Tam NKB, Anh NTK. Occurrence of antibiotic residues and antibiotic-resistant bacteria in effluents of pharmaceutical manufacturers and other sources around Hanoi, Vietnam. Sci Total Environ. 2018;645:393–400.

Bridson E, Brecker A. Design and formulation of Microbiological culture media. In J.R. Noris and D.W. Ribbons (Editors). Methods in Microbiology, Academic Press London. 1970;3:229-296.

Vanderzantz C, Splittstoesser DF. Compendium of methods for the microbiological examination of foods Washington, DC. Am Pub HlthAsso. 1992; 3:92-98.

Hartmann A, Alder A, Koller T, Widmer R. Identification of fluoroquinolone antibiotics as the main source of genotoxicity in native hospital wastewater. Env Toxicol Chem. 1998;17:377-382.

Thakali O, Tandukar S, Brooks JP, Sherchan SP, Sherchand JB, Haramoto E. The Occurrence of Antibiotic Resistance Genes in an Urban River in Nepal. Water. 2020;12:450.

Radhakrishna L, Prabhu N, Suvidya SV, Thirumalaikolundusubramanian P. Knowledge, Attitude and Practice towards disposal of medicines; A qualitative study among health care professionals in South India. Wld J Pharm Res. 2014;3:1955-1963.

Krushna CS, Tamhankar AJ, Eva J, Cecilia L. Antibiotic use, resistance development and environmental factors; A qualitative study among healthcare professionals in Orissa, India. BMC Pub Hlth. 2010;10:629-634.

Mohsen H, Maryam K, Bijan B, Afshin E, Mehdi A, Mohammad G, Mohammad M. A qualitative survey of five antibiotics in water treatment plants in Central Plateau of Iran. J Env Pub Hlth 2013;2013: 351-358.

Rayco GA, Cristina AO, Sarah ME, Zoraida SF, Jose SR. An assessment of the concentrations of pharmaceutical compounds in waste water treatment plants on the island of Gran Canaria Spain. 2013;2:24-29.

Tell J, Daniel J C, Andreas H, Jutta H, Birgit H, Romain J, Frank M. Science‐based Targets for Antibiotics in Receiving Waters from Pharmaceutical Manufacturing Operations. Integ Envt Asmnt and Mangmt. 2019;15(3): 312–19.

Pravin KM, Atul KM. Risk assessment of antibiotic residues in different water matrices in India. Environ Sci Pollut Res. 2014;21:7723-7736.

Hocquet D, Muller A, Bertrand X. What happens in hospitals does not stay in hospitals: Antibiotic-resistant bacteria in hospital wastewater systems. J Hospital Infect. 2016;93(4):395–402.