Aquatic Environmental Risk Assessment for Human Use of the Old Antibiotic Sulfamethoxazole in Europe
Abstract
Sulfamethoxazole (SMX) is an old sulfonamide antibiotic that was launched first in combination with trimethoprim in 1969 by F.Hoffmann-La Roche. Although sales figures for SMX have been declining over the past 20 yr, the compound is still widely used; moreover, many measured environmental concentrations (MECs) are available from Europe, the United States, Asia, Australia, and Africa. To assess aquatic risks of SMX in Europe, the exposure of European surface waters was predicted based on actual sales figures from IMS Health, incorporating environmental fate data on one side, and based on collated MECs representing more than 5500 single measurements in Europe on the other. Environmental effects were assessed using chronic and subchronic ecotoxicity data for 16 groups of aquatic organisms, from periphyton communities to cyanobacteria, algae, higher plants, various invertebrates, and vertebrates. Predicted no-effect concentrations (PNECs) were derived using both deterministic and probabilistic methodology. The predicted environmental concentration (PEC)/PNEC and MEC/PNEC comparisons overall showed no appreciable risk, except in a low incidence (<0.55%) of cases in which exceptionally high MECs led to MEC/PNEC risk characterization ratios greater than 1. The PNECs derived in the present study can be used to extend aquatic environmental risk assessment for SMX to other continents. No risk appears for indirect human exposure to SMX via the environment.
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Back-transformation may distort sulfamethoxazole removal rates when occurring disproportionally before and after treatment.
“back-transformation may distort these rates when occurring disproportionally before and after treatment [12].”
From Pharmacometabolomics Study of Sulfamethoxazole and Trimethoprim in Kidney Transplant Recipients: Real-World Metabolism and Urinary Excretion (2025) · cites this paper as [12]
Sulfamethoxazole levels detected in environmental samples occasionally exceed the predicted no-effect concentration threshold in the low microgram per Liter range, indicating a risk to aquatic ecosystems.
“its levels detected in environmental samples occasionally exceed the so-called predicted no-effect concentration (PNEC) threshold value, which resides in the low microgram per Liter range, indicating a risk to aquatic ecosystems [11,12].”
From Pharmacometabolomics Study of Sulfamethoxazole and Trimethoprim in Kidney Transplant Recipients: Real-World Metabolism and Urinary Excretion (2025) · cites this paper as [12]
Acetylsulfamethoxazole has reduced biological activity/toxicity compared to sulfamethoxazole.
“acetylsulfamethoxazole’s reduced biological activity/toxicity compared to sulfamethoxazole may limit the relevance of measuring it [12,42,43].”
From Pharmacometabolomics Study of Sulfamethoxazole and Trimethoprim in Kidney Transplant Recipients: Real-World Metabolism and Urinary Excretion (2025) · cites this paper as [12]
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“Admittedly, acetylsulfamethoxazole’s reduced biological activity/toxicity compared to sulfamethoxazole may limit the relevance of measuring it [12,42,43].”
Influential
- Authors
- Straub, J. O.
- Affiliations
- F. Hoffmann-La Roche AG (CH)
- Corresponding author
- Straub, Jürg Oliver
- ORCID
- Straub, Jürg Oliver
- Venue
- Environmental Toxicology and Chemistry
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-02-18
- Volume
- 35
- Issue
- 4
- Pages
- 767-779
- ISSN
- 0730-7268 (ISSN-L)
- 1552-8618
- OpenAlex
- W2098390402
- Cited by
- 154
- References
- 94
- Citations by year
- 2026: 16 · 2025: 17 · 2024: 17 · 2023: 29 · 2022: 19 · 2021: 16 · 2020: 9 · 2019: 8 · 2018: 6 · 2017: 11 · 2016: 5 · 2015: 1
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Environmental Toxicology and Chemistry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Environmental Toxicology and Ecotoxicology
- Physical Sciences › Environmental Science › Pollution › Pesticide and Herbicide Environmental Studies
- Keywords
- sulfamethoxazole, sulfonamide antibiotics, aquatic toxicity, environmental risk assessment, predicted no-effect concentration, pharmaceutical sales data, environmental fate, chronic ecotoxicity, Europe
- MeSH terms
- Animals, Anti-Bacterial Agents, Environmental Monitoring, Europe, Fresh Water, Humans, Sulfamethoxazole, Water Pollutants, Chemical, Risk Assessment, No-Observed-Adverse-Effect Level, Aquatic Organisms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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