The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing
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...
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doaj-57c35275e5c04274a7ed39abd239fea12020-11-25T01:14:47ZengTaylor & Francis GroupInfection Ecology & Epidemiology2000-86862018-01-018110.1080/20008686.2018.15534631553463The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testingSofia Svebrant0Therese Olsen1Jim Larsson2Patrik Öhagen3Hanna Söderström4Josef D. Järhult5Uppsala University Hospital, Uppsala County CouncilUppsala University Hospital, Uppsala County CouncilUppsala University Hospital, Uppsala County CouncilUppsala UniversityUmeå UniversityUppsala UniversityIntroduction: 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.http://dx.doi.org/10.1080/20008686.2018.1553463APIenviromentantibiotic resistancewaste waterpharmaceuticalssewage treatment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sofia Svebrant Therese Olsen Jim Larsson Patrik Öhagen Hanna Söderström Josef D. Järhult |
spellingShingle |
Sofia Svebrant Therese Olsen Jim Larsson Patrik Öhagen Hanna Söderström Josef D. Järhult The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing Infection Ecology & Epidemiology API enviroment antibiotic resistance waste water pharmaceuticals sewage treatment |
author_facet |
Sofia Svebrant Therese Olsen Jim Larsson Patrik Öhagen Hanna Söderström Josef D. Järhult |
author_sort |
Sofia Svebrant |
title |
The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing |
title_short |
The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing |
title_full |
The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing |
title_fullStr |
The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing |
title_full_unstemmed |
The enzyme toilet rim block ‘pCure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing |
title_sort |
enzyme toilet rim block ‘pcure’ does not efficiently remove drug residues in a hospital setting - exemplifying the importance of on-site implementation testing |
publisher |
Taylor & Francis Group |
series |
Infection Ecology & Epidemiology |
issn |
2000-8686 |
publishDate |
2018-01-01 |
description |
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. |
topic |
API enviroment antibiotic resistance waste water pharmaceuticals sewage treatment |
url |
http://dx.doi.org/10.1080/20008686.2018.1553463 |
work_keys_str_mv |
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