Veterinary pharmaceutical residues from natural water to tap water: Sales, occurrence and fate.

Veterinary pharmaceuticals (VPs) increasingly used in animal husbandry have led to their presence in aquatic environments -surface water (SW) or groundwater (GW) - and even in tap water. This review focuses on studies from 2007 to 2017. Sixty-eight different veterinary pharmaceutical residues (VPRs) have been quantified worldwide in natural waters at concentrations ranging from nanograms per liter (ng L-1) to several micrograms per liter (µg L-1). An extensive up-to-date on sales and tonnages of VPs worldwide has been performed. Tetracyclines (TCs) antibiotics are the most sold veterinary pharmaceuticals worldwide. An overview of VPRs degradation pathways in natural waters is provided. VPRs can be degraded or transformed by biodegradation, hydrolysis or photolysis. Photo-degradation appears to be the major degradation pathway in SW. This review then reports occurrences of VPRs found in tap water, and presents data on VPRs removal in drinking water treatment plants (DWTPs) at each step of the process. VPRs have been quantified in tap water at ng L-1 concentration levels in four studies of the eleven studies dealing with VPRs occurrence in tap water. Overall removals of VPRs in DWTPs generally exceed 90% and advanced treatment processes (oxidation processes, adsorption on activated carbon, membrane filtration) greatly contribute to these removals. However, studies performed on full-scale DWTPs are scarce. A large majority of fate studies in DWTPs have been conducted under laboratory at environmentally irrelevant conditions (high concentration of VPRs (mg L-1), use of deionized water instead of natural water, high concentration of oxidant, high contact time etc.). Also, studies on VPRs occurrence and fate in tap water focus on antibiotics. There is a scientific gap on the occurrence and fate of antiparatic drugs in tap waters.

Antibiotics in the treatment of acute exacerbations of chronic bronchitis.

The benefit of antimicrobial therapy for patients with an acute exacerbation of chronic bronchitis (AECB) remains controversial for two main reasons. First, the distal airways of patients with chronic bronchitis are persistently colonised, even during clinically stable periods, with the same bacteria that have been associated with AECB. Second, bacterial infection is only one of several causes of AECB. These factors have led to conflicting analyses on the role of bacterial agents and the response to antimicrobial therapy of patients with AECB. An episode of AECB is said to be present when a patient with chronic obstructive pulmonary disease (COPD) experiences some combination of increased dyspnoea, increased sputum volume, increased sputum purulence and worsening lung function. While the average COPD patient experiences 2 - 4 episodes of AECB per year, some patients, particularly those with more severe airway obstruction, are more susceptible to these attacks than others. Bacterial agents appear to be particularly associated with AECB in patients with low lung function and those with frequent episodes accompanied by purulent sputum. Non-typeable Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis account for up to 50% of episodes of AECB. Gram-negative bacilli are more likely to occur in patients with more severe lung disease. Antibiotics have been used to ameliorate AECB, to prevent AECB and to prevent the long-term loss of lung function that characterises COPD. Numerous prevention trials have been conducted with fairly consistent results; antibiotics do not lessen the number of episodes of AECB but do reduce the number of days lost from work. Most antibiotic trials have studied the impact of treatment on episodes of AECB and results have been inconsistent, largely due to patient selection and end point definition. In patients with severe airway obstruction, especially in the presence of purulent sputum, antibiotic therapy significantly shortens the duration of symptoms and can be cost-effective. Over the past 50 years, virtually all classes of antimicrobial agents have been studied in AECB. Important considerations include penetration into respiratory secretions, spectrum of activity and antimicrobial resistance. These factors limit the usefulness of drugs such as amoxicillin, erythromycin and trimethoprim-sulfamethoxazole. Extended-spectrum oral cephalosporins, newer macrolides and doxycycline have demonstrated efficacy in clinical trials. Amoxicillin-clavulanate and flouoroquinolones should generally be reserved for patients with more severe disease. A number of investigational agents, including ketolides and newer quinolones, hold promise for treatment of AECB.