ArticlePNAS nexus2025
Antibiotics in the global river system arising from human consumption.
Article in PNAS nexus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed.
- Article
- Lewis-acid activation of persulfate enables oxidation of antibiotics: a new green low-cost advanced oxidation process.RSC advances · 2026Article
- Phytoplankton Community Structure and Aquatic Ecological Health in the Tongyang River Basin (China) and Their Response to Nutrients Reduction Project.Water environment research : a research publication of the Water Environment Federation · 2026Article
- Enhanced degradation of tetracycline (TC) by FeCoNiCuAl high-entropy alloy powders through ball milling.RSC advances · 2026Article
- Magnetically actuated miniature bamboo-fiber robots for antibiotic removal from water.iScience · 2026Article
- Nitrate-reducing bacteria bridge nitrogen cycling and antibiotic resistance in river ecosystems.Nature communications · 2026Article
- Analysis and Risks of Emerging Contaminants and Microplastics in Natural and Treated Waters and Human Health: A Critical Review.Journal of xenobiotics · 2026Review
- Breaking Lock-ins to Enable a Green Pharmacy.Environmental science & technology · 2026Review
- Nanocellulose Membranes for Plasmon-Enhanced Removal of Organic Pollutants from Water.ACS applied nano materials · 2026Article
- Long-term spatiotemporal dynamics of β-lactamase resistome in the Han River, South Korea.Frontiers in microbiology · 2026Article
- Occurrence of Virulence and Antibiotic Resistance inAntibiotics (Basel, Switzerland) · 2025Article
- Assessing the Ecotoxicological Effects of Emerging Drug and Dye Pollutants on Plant-Soil Systems Pre- and Post-Photocatalytic Wastewater Treatment.Plants (Basel, Switzerland) · 2025Review
- Limited integration of one health and antimicrobial resistance within biodiversity strategies.Discover public health · 2025Review
- Antibiotic Resistance in the Philippines: Environmental Reservoirs, Spillovers, and One-Health Research Gaps.Frontiers in microbiology · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The presence of antibiotics in surface waters poses risks to aquatic ecosystems and human health due to their toxicity and influence on antimicrobial resistance. After human consumption and partial metabolism, antibiotic residues are excreted and undergo complex accumulation and decay processes along their pathway from wastewater to natural river systems. Here, we use a global contaminant fate model to estimate that of the annual human consumption of the 40 most used antibiotics (29,200 tonnes), 8,500 tonnes (29%) are released into the river system and 3,300 tonnes (11%) reach the world's oceans or inland sinks. Even when only domestic sources are considered (i.e. not including veterinary or industrial sources), we estimate that 6 million km of rivers worldwide are subject to total antibiotic concentrations in excess of thresholds that are protective of ecosystems and resistance promotion during low streamflow conditions, with the dominant contributors being amoxicillin, ceftriaxone, and cefixime. Therefore, it is of concern that human consumption alone represents a significant risk for rivers across all continents, with the largest extents found in Southeast Asia. Global antibiotic consumption has grown rapidly over the last 15 years and continues to increase, particularly in low- and middle-income countries, requiring new strategies to safeguard water quality and protect human and ecosystem health.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.