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The enzyme toilet rim block 'pCure' does not efficiently remove drug residues in a hospital setting: exemplifying the importance of on-site implementation testing
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2018 (English)In: Infection Ecology & Epidemiology, ISSN 2000-8686, E-ISSN 2000-8686, Vol. 8, no 1, article id 1553463Article in journal (Refereed) Published
Abstract [en]

Introduction: Negative environmental effects of active pharmaceutical ingredients (APIs) are increasingly recognized, especially concerning antibiotics, and hospitals are important point sources. "pCure" is a toilet rim block containing API-degrading enzymes; the producing company claims positive in vitro results but no implementation studies have been performed.

Materials and methods: In a university hospital setting, 16 weeks were randomized to installation or no installation of pCure in all 261 toilets connected to the same cesspit where sewage water was sampled daily. Ninety-six samples were analyzed for 102 APIs using liquid chromatography/tandem mass spectrometry.

Results and Discussion: Fifty-one APIs were detected with a large variation in levels but no significant differences in the initial statistical analysis. More statistical testing of API level ratios (pCure installed/not installed) yielded some cases of significant decrease. Differences were small and not consistent when comparing means and medians. We cannot exclude a small pCure effect but clearly pCure has no effect of biological importance. Conclusion: pCure is not useful to reduce drug residue discharge in a hospital setting. In a bigger perspective, our study exemplifies that products claiming to reduce an environmental problem need to be tested in on-site implementation studies by independent researchers before reaching the market.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018. Vol. 8, no 1, article id 1553463
Keywords [en]
API, antibiotic resistance, enviroment, pharmaceuticals, sewage treatment, waste water
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-157379DOI: 10.1080/20008686.2018.1553463PubMedID: 30847040OAI: oai:DiVA.org:umu-157379DiVA, id: diva2:1296739
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-03-19Bibliographically approved

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Söderström, Hanna

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