Research Advances on the Distribution and Risk of Amoxicillin in Aquatic Ecosystems

Amoxicillin,as one of the most commonly used broad-spectrum antibiotics clinically,has been widely detected in diverse aquatic environments,wherein their distribution and risk need urgent attention.Concentrations and detection frequencies of amoxicillin in aquatic ecosystems were compiled from 81 relevant articles published from 2003 to 2022.We established a database of amoxicillin and analyzed its distribution and risk in influents and effluents of sewage treatment plants,surface water,groundwater,and drinking water.The results showed that amoxicillin concentrations ranged from ng/L to μg/L across different water systems.Significantly higher concentrations and detection frequencies of amoxicillin were observed in influents and effluents of sewage treatment plants and surface water compared to groundwater and drinking water (p<0.05,Kruskal Wallis ANOVA).Surface water in less developed countries or emerging economies exhibited substantial pollution levels,with the highest concentrations reaching several hundreds of μg/L.Rivers generally showed relatively higher amoxicillin concentrations than lakes and reservoirs,likely due to the increased anthropogenic disturbances.Amoxicillin posed high risks to algae in urban rivers and coastal waters characterized by intensive human activities,and its potential to promote the development of antimicrobial resistance cannot be overlooked.