A report from the United Nations Environmental Program offers a useful summary of how the presence of low concentrations of antibiotics in the environment can lead to bacterial antibiotic resistance.
According to the report, antibiotics make it into the natural ecosystem in three ways; 1) via improper disposal of unused prescriptions of antibiotics, 2) through the inadequate treatment of wastewater, and 3) in agricultural waste as a result of the heavy use of antibiotics in farm animals. The report suggests that these low concentrations of antibiotics contribute to antibiotic resistance. In other words, it's not just the over-prescribing of antibiotics for humans that leads to antibiotic resistance; it's also a slow, ongoing process as a result of current environmental contamination. In addition, we know very little about how certain other substances in the environment, such as heavy metals, further contribute to antibiotic resistance.
If the report is correct, we may need to pay more attention to sewage and wastewater treatment, as well as working toward curbing the over-prescribing of antibiotics for farm animals, as well as for humans.
The report contains a handy visual flow chart (p. 15) that teachers might use to explain this subject to students.
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