Occurrence of selected antibiotics in urban rivers in northwest Pakistan and assessment of ecotoxicological and antimicrobial resistance risks.

Antibiotics in aquatic systems of developing countries are a growing concern, particularly with the potential ecological risks and emergence of antimicrobial resistance. In Pakistan, antibiotics are widely consumed and released untreated into rivers, however, there is little information on their occurrence and potential risks. In this study, the concentrations and risk assessment of three commonly consumed antibiotics, ciprofloxacin (CIP), amoxicillin (AMX), and cefixime (CFM) belonging to different classes of fluoroquinolone, penicillin, and cephalosporin respectively were investigated in the Kabul River and its two tributaries, Bara River and Shah Alam River in the northwest region of the country. Composite samples were collected in different sampling campaigns and analyzed using the LC-ESI-MS/MS technique. All three antibiotics were found in higher concentrations ranging from 410 to 1810 ng/L, 180-850 ng/L, and 120-600 ng/L for CIP, AMX, and CFM respectively. The Friedman and Wilcoxon signed-ranked tests revealed insignificant differences in average concentrations of each antibiotic in the three rivers and the Pearson Correlation showed a significant positive correlation of CIP with both AMX and CFM indicating their similar pollution sources. Ecotoxicological risk assessment showed a higher risk to algae and bacteria (P. putida) in the rivers with CIP posing a greater risk. The potential risk of antimicrobial resistance development (ARD) was higher in all the three rivers, particularly in Kabul River where maximum risk quotients (RQARD) of 28.3, 9.4 and 3.4 were noted for CIP, CFM and AMX respectively. The human health (HH) risk was insignificant, though the RQHH was higher for the lower age groups (0-3 months). In addition, the combined flux of the antibiotics in the Kabul River was estimated as 59 tons/year with CIP having a significant flux relative to the other antibiotics.