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expert reaction to modelling study on antibiotics in the Thames

Research, published in PLOS ONE, reports that three-quarters of the length of the Thames river contains levels of antibiotics which are high enough to allow ‘super bugs’ to develop resistance to the antibiotics that they have been exposed to.  


Prof Laura Piddock, Professor of Microbiology, University of Birmingham, said:

“In essence, the authors have suggested that reducing the number of prescriptions of two antibiotic classes will reduce the number of bacteria resistant to those same drug classes in the River Thames.  

“However, at no time has there been an indication of the correlation between the numbers of drug-resistant bacteria in river water and incidence of infections in people that are difficult to treat. It is important that such work is put into perspective as the majority of serious infections by the gut bacteria alluded to in this manuscript are not acquired via river water, and if an infection were acquired it would likely be gastroenteritis which is rarely treated with antibiotics.”


Prof Mark Woolhouse, Professor of Infectious Disease Epidemiology, University of Edinburgh, said:

“This study gives us a better understanding of how antibiotic pollution might generate antimicrobial resistance in our waterways. Based on the information currently available the authors estimate the risk that the concentrations of antibiotics in the Thames river system are sufficient to generate antimicrobial resistance in bacteria.

“With the caveat that these are estimates, not observations, the results are worrying, suggesting that very high reductions in antibiotic concentrations in river water would be necessary to eliminate that risk. There is increasing concern worldwide about antibiotics and antimicrobial resistance bacteria in the aquatic environment. Quantitative studies of this type are an important step towards assessing the magnitude of the problem and how it might be addressed.”


Dr Lisa Avery, environmental microbiologist at the James Hutton Institute, said:

“While modelling studies can only produce estimates of the required reductions in AMR and, as the authors acknowledge, there are inevitably assumptions made and limitations to the predictions, this appears to be a good quality study that highlights the increasing level of concern over antibiotic usage and subsequent entry into the environment.

“The key message is that a multi-pronged approach is needed to tackle antimicrobial resistance. Reducing prescribing is part of that, but development of new wastewater treatment technologies may be needed to see a real step change in perpetuation of antimicrobial resistance in our environments. At the James Hutton Institute, we are involved in a number of projects addressing AMR prevalence in the environment both in the UK and internationally and understanding the prevalence of resistance in the catchment underpins our research.”


‘Translating antibiotic prescribing into antibiotic resistance in the environment: a hazard characterisation case study’ by Andrew C. Singer et al. was published in PLOS ONE at 7pm UK TIME on Wednesday 4 September 2019. 


Declared interests

None received. 

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