Professor Renier Coetzee, Deputy President of the South African Pharmacy Association and a faculty member at the University of the Western Cape (UWC) School of Public Health, has warned that pharmaceutical waste detected in municipal wastewater poses a significant risk to public health.

He suggests that to mitigate these risks, it is crucial to use medication take-back programmes available at pharmacies instead of flushing medications down toilets or sinks.

“This is a serious issue that demands our attention. By raising awareness and promoting proper disposal methods, we can protect our environment, safeguard public health, and combat the threat of antibiotic resistance,” said Prof Coetzee.

He suggested that by understanding the impact of improper antibiotic disposal, steps can be taken to protect our health and the environment.

“The key is to make informed choices and ensure a healthier future for everyone,” said Prof Coetzee.

“The improper disposal of antibiotics, for instance, poses a serious threat. Antimicrobials from human and veterinary medicine can enter waterways through pharmaceutical manufacturing, agricultural runoff, and the disposal of leftover medicines.

“In oceans and rivers, even low levels of antibiotics can promote the development of antimicrobial-resistant genes, which can spread across species and ecosystems. Given the interconnectedness of our food chain, this cycle makes it harder to treat bacterial infections, leading to increased antibiotic use, further exacerbating the problem.”

Prof Coetzee highlighted the critical nature of this issue, emphasising that improper disposal methods are a widespread concern.

A study in Australia he has been involved in underscores this concern. Of 1,577 pharmacists surveyed across the country, more than 59% recommended incorrect disposal methods for leftover antibiotic syrup, such as putting it in the trash or down the sink.

Alarmingly, 10 pharmacists even suggested pouring the syrup on grass, soil, or into a street drain. Some pharmacists were hesitant to provide disposal advice at all, with a few recommending contacting the prescriber. Notably, 1.3% of the pharmacists who advised returning the antibiotics to the pharmacy admitted they would pour it down the sink once returned, further contaminating the environment.

Pharmacies are required by law to take back expired or unused medications and this is the only recommended method of disposal in South Africa.

For more information on safe disposal practices, consult your local municipality’s website or health department. The best option is to find a medicine take-back location, such as a local pharmacy or police station.