Antibiotics Use in Hospitals and Their Presence in the Associated Waste

Over the last two to three decades, a large number of antibiotics from different groups have been developed to cure variety of bacterial infections in hospitals. These antibiotics, when administered orally to the patients, resulted in the detection of large amounts of antibiotics in hospital waste through excretion due to their limited metabolization in human body, coupled with the inappropriate use in the hospitals. Further, many antibiotic-resistant bacteria present in patient intestine also enters the hospital waste through excretion. The primary treatment system to treat hospital waste does not exist in developing countries. This issue is also pronounced in many developed regions and result in the release of large amount of antibiotics, antibiotic-resistant bacteria, and antibiotic resistance genes in the hospital waste. The hospital waste will create conditions that are conducive for the bacteria not only to multiply but also help to share their resistance genes with other bacteria through mobile genetic elements. Thus, the antibiotics and antibiotic-resistant bacteria that were present in the hospital waste can reach the drinking water, surface water, and marine and soil environment where they can cause variety of problems through altering the ongoing processes in the ecosystem, toxicity to various species followed by the threat to humans through food chain.