Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Cefuroxime

Hazard 6* P 3 B 0 T 3* Risk See below

Information

Previously there was a risk of selection of antibiotic resistant bacteria in wastewater. However, in the Stockholm County Council sales have been decreasing a lot since 2011, and now the risk of resistance development is considered to be low in the county.

In selection of algae for toxicity testing of antibiotics the European Medicines Agency, EMA, recommends test on blue-green algae (cyanobacteria). No information on toxicity on blue-green algae has been found, which means that a calculation of environmental risk becomes uncertain.

The risk classification insignificant, according to Fass.se, is based on total sold amount (kg) of the substance in Sweden during the year 2014 and the toxicity of the substance.

References

  1. Goodpoint. Prioritering av läkemedel med miljörisk inom SLL. Stockholm: Goodpoint; 2016. Rapport LS 2016–0634.
  2. Sammanställning av läkemedelsprovtagningar - Bearbetning av regional försäljningsstatistik av läkemedel samt datamaterial från Stockholms läns landstings mätprogram för läkemedelssubstanser i vattenmiljön, 2005-2012. Trossa AB På uppdrag av Stockholms läns landsting. 2014.
  3. IVL Swedish Environmental Research Institute Ltd Fick J, Lindberg RH, Fång J, Magnér J, Kaj L, Brorström-Lundén E. Screening 2014. Analysis of pharmaceuticals and hormones in samples from WWTPs and receiving waters. Rapport C 135.
  4. IVL Swedish Environmental Research Institute Ltd. Fick J, Lindberg RH, Kaj L, Brorström-Lundén E. Results from the Swedish National Screening Programme 2010. Subreport 3, B 2014 Pharmaceuticals.
  5. Fick J, Lindberg RH, Tysklind M, Larsson DG. Predicted critical environmental concentrations for 500 pharmaceuticals. Regul Toxicol Pharmacol. 2010;58:516-23.
  6. Bengtsson-Palme J, Larsson DG. Concentrations of antibiotics predicted to select for resistant bacteria: Proposed limits for environmental regulation. Environ Int. 2016;86:140-9.
  7. Kümmerer K, Alexy R, Hüttig J, Schöll A. Standardized tests fail to assess the effects of antibiotics on environmental bacteria. Water Res. 2004;38:2111-6.
  8. European Medicines Agency, EMA: Committee for Medicinal Products for Human Use (CHMP). Guideline on the Environmental Risk Assessment of Medicinal Products for Human Use. 1 June 2006.
  9. Fass.se för vårdpersonal

Author: The Pharmaceutical unit of Region Stockholm