Management of Macrolide Antibiotics (Erythromycin, Clarithromycin and Azithromycin) in the Environment: A Case Study of Environmental Pollution in Lithuania

Of all the antibiotics used today for human treatment in world, macrolide antibiotics—erythromycin, clarithromycin and azithromycin—stand out most misuse, they were included as high-risk substances monitoring Watch List of Regulation 2018/840/EU. The aim present research was to investigate level target pharmaceuticals’ prevalence environment by substance flow analysis (SFA) approach determine potential risks environment. environmental investigations Lithuania. For SFA, 2021 consumption input data used, such key processes rate, disposal distribution pharmaceuticals analyzed. revealed that largest part pharmaceutical contaminants (80.1%) enters wastewater plants. risk quotient based on determination predicted concentrations (PECs), measured (MECs) their ratio no-effect (PNECs). causes a high aquatic effluents from plants (WWTP); PEC/PNEC > 7. azithromycin erythromycin, estimated PEC values between 0.1 1. Clarithromycin concentration two WWTPs showed significant (MEC/PNEC) higher than Recommendations how reduce release residues into have been proposed framework management system.