Ecopharmacology: A New Topic of Importance in Pharmacovigilance

Excerpt

In 1999, >13 000 tonnes of antibacterials were used in the European Union (EU).[1] According to an estimate by Wise, 100 000 tonnes of antibacterials may be used annually.[2] It has been estimated that several 100 000 tonnes of pharmaceuticals are sold worldwide per year. After administration, most drugs are incompletely metabolised. For example, using data from Germany, an average excretion rate for antibacterials of 75% for the unchanged drug was calculated using amounts used and compound-specific excretion rates.[3] Active compounds are excreted into the environment through faeces and urine. Surplus drugs not taken by patients are often disposed of down the drain or with waste. Drugs from various groups, such as cytotoxic agents, antibacterials, analgesics, spasmolytics, sedatives, x-ray and MRI contrast media and disinfectants have been detected in the terrestrial and aquatic environment throughout the world.[4‐6] This indicates that they are not fully eliminated, for example, by the treatment of effluent. The most important routes by which pharmaceuticals enter the environment are depicted in figure 1. Pharmaceuticals applied in veterinary medicine enter the environment mainly through manure and thereafter move into the soil from where they may trickle down into the ground water.

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