Healthcare

Drug overdose

New study renews Chinese debate on antibiotics

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China consumes far too many

China’s rivers and lakes are notoriously polluted – heavy metals, industrial effluent and fertilisers all swirl within their waters. But a new study released last week suggests they are also carrying huge amounts of active antibiotics.

The finding is unsettling for several reasons.

As scientists 0f the Guangzhou Institute of Geochemistry point out, it’s very likely the medicine has in turn found its way into the country’s drinking water too. Secondly, it raises the possibility that the rivers themselves could become sources of drug resistant bacteria – and thus in the coming years be the breeding ground for some deadly virus that’s immune to our existing arsenal of antibiotic cures.

“The present study found alarming nationwide overuse and emission of various antibiotics. This has resulted in the relatively high environmental concentrations and increased antibiotic resistance in hospitals,” it said. According to the report China consumes over 16,000 tonnes of antibiotics every year – 48% of which goes to humans, 52% of which goes to animals.

The problem? While antibiotic use in animals is also high elsewhere, most of the Chinese emissions are not treated. The report measured the presence of 36 commonly used antibiotics and found that freshwater lakes such as Dongting in Hunan province received more than 3,400 tonnes of antibiotic discharge. The 10 year survey studied all 58 of China’s major river basins and found, perhaps unsurprisingly, the Yangtze, the Yellow River and the Pearl River all carry huge quantities of antibiotics too.

Worryingly Taihu Lake, which provides drinking water for about 30 million people in Shanghai, Zhejiang and Jiangsu, was also listed as one of the worst cases.

As the Global Times pointed out, China doesn’t test drinking water for the presence of antibiotics, meaning it is almost certain that people are imbibing the drugs unknowingly. This claim is backed up by another report published by Fudan University earlier this year which found that the urine of children in Shanghai, Zhejiang and Jiangsu contained traces of antibiotics they weren’t (knowingly) taking.

The report said they had ingested the medicines through water and food. “The findings were alarming. Being exposed to low level of antibiotics for a long time can result in drug resistance [i.e. if you do get sick, antibiotics won’t cure you anymore] as well as leading to intestinal disease, asthma, obesity and even tumours,” China.org.cn quoted one of the authors as saying.

Both reports say that part of the solution has to be the reduction of the country’s rampant overuse of antibiotics. The researchers claims China uses 150 times more antibiotics than the UK (though the population is only 23 times bigger) and individual doses of medicines are often six times larger.

However, the reports do acknowledge that since 2011 the Chinese government has been working to reduce the over-prescription of antibiotics. Outpatients are now prescribed antibiotics in 15% of cases and inpatients receive them 58% percent of the time, according to the Ministry of Health. These figures are down from 25% and 68% respectively before 2011.

The number of patients given antibiotics after surgery has also dropped from 98% to 58% and the average duration of drug use has been shortened from five days to 48 hours.

So how to get antibiotics out of the nation’s waterways? The Guangzhou scientists said the most important step is to introduce “treatment” rules for animal waste.

China is home to 600 million pigs and 5 billion chickens all of which are dosed up on antibiotics. As the situation stands their waste is simply spread on land or dumped in rivers. The report found that of the 36 chemicals they were testing for, 84% had been excreted into China’s waters by animals. With food also a major conduit for inadvertent antibiotic consumption there is therefore a strong argument for reducing the amount of drugs given to Chinese livestock. But that is a battle even environmentalists in the US are finding tough (thanks to powerful lobbyists). For now, China’s best option might be to install more water treatment plants.


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