Antibiotic contamination in environment and implications on planetary health: a comprehensive perspective of China

The rising use of antibiotics in China, primarily from sewage sludge, wastewater irrigation, and manure applications, has led to widespread environmental contamination, disrupting ecosystems and accelerating the proliferation of antibiotic resistance. This review examines the widespread issue of antibiotic contamination in China, focusing on the distribution of common antibiotics across various environmental matrices. Fluoroquinolone concentrations in surface water range from 15.4 to 567.0 ng/l, while tetracycline residues in sediments reach up to 292.5 ng/g. In soils, antibiotic levels can exceed 2.13 × 105 ng/g, and fluoroquinolones in aquatic organisms are found at concentrations as high as 47,000 ng/g. These findings, based on data collected between 2000 and 2020, highlight that fluoroquinolones predominate in aquatic environments due to persistent discharge, while tetracyclines accumulate in soils and sediments due to their strong adsorption and slow degradation. Human exposure to antibiotics, especially through contaminated food and water, exacerbates the spread of antimicrobial resistance, particularly in Escherichia coli, in both clinical and dietary contexts. We introduce the planetary boundary and One Health frameworks, which provide guidance for global and national mitigation efforts to safeguard planetary health and combat the growing threat of antimicrobial resistance. The solutions include improving wastewater treatment technologies and regulating manure use in agriculture for better mitigation of antibiotic residues. This review concludes that antibiotic contamination has widespread ecological and health impacts and calls for global policy frameworks to limit environmental contamination.