In the last two decades, we have seen the surge of four major viral outbreaks which pretended serious lethality to human beings. In the year 2002, the world faced the emergence of the epidemic in the form of Severe Acute Respiratory Syndrome (SARS) Coronavirus (CoV), further in 2009 the spread of influenza H 1 N 1 and in last seven years, two major outbreaks i.e., Middle East Respiratory Syndrome (MERS) in 2012 and the recent pandemic of COVID-19.
It is also observed that sometimes, viral respiratory infections are associated with bacterial co-infections that increase the risk for mortality and morbidity. Including this, the prolonged usage of invasive catheters and incubation during the treatment, (for example treatment of COVID-19 patients) indirectly increased the risk for bacterial and fungal co-infection that further produced complications in the treatment. Rapidly spreading infections increased the demand for antibiotics.
After the consumption, antibiotics are partially metabolized by the liver and these are excreted out with urine. Surprisingly, about 30-90% of metabolized or un-metabolized antibiotics and other pharmaceutical products are released into the wastewater by excretion.
Moreover, increasing use/misuse of antibiotics has indirectly increased the concentration of these products into the environment which has its potential risk to human health, aquatic system and risk for development of antibiotic resistance in microorganisms.
This overuse of antibiotics will have worsening effects on the post-pandemic time. Even, the highest Indian authority on medical research i.e. Indian Council of Medical Research (ICMR) states that half of the COVID-19 patients who have developed bacterial or fungal co-infection have died. This pandemic has caused an outbreak of several other associated diseases that has the potential to drive microbial resistance. In future antimicrobial resistance (AMR) could cause about one crore deaths every year by 2050 (United Nations report).
The traditional wastewater treatment plants are not capable to eliminate these antibiotics neither completely nor partially, hence their residues can be detected in the surrounding environment. Hence, administrations and prescriptions of these drugs should be optimized and preventive measures and personal hygiene should be given the top priority. It is a commonly accepted fact that weakening of the antibiotic efficacy has increased concern about major societal threat, irrespective of developed or developing country or the superiority of their health infrastructure.
India is having highest bacterial disease load among the other countries, then role of antibiotics is expanding from handling serious infections. In India, people are consuming antibiotics without a medical subscription, and expired/unused pills are generally littered in an open environment. Besides, the application of antibiotics in livestock is increasing and it would indirectly seep into soil as well as water bodies through manure and urination.
According to the Scoping Report on Antimicrobial Resistance in India, Nov. 2017, the consumption of cephalosporin (3 rd generation antibiotic) is about 30% among all kinds of antibiotics used in India, and removal/degradation of antibiotics is not easy.
Indigenous research and development is the need of the hour which would benefit more and more people, shall ensure self-sustainability, and shall address the prevailing diverse socio-economic condition of Indians. New STPs with novel technology has the capability to remove not only antibiotics but most of the pharmaceuticals from wastewater would be installed to save coming generations with AMR (Anti-microbial resistance). Which will further open up new vistas of knowledge in the area of management of these challenge
Views expressed above are the author’s own.
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