What Water Professionals Should Know about Antibiotics and Antibiotic Resistance: An Overview

In light of recent predictions that by 2050, antimicrobial resistance will cause almost 10 million deaths annually, costing the global economy 100 trillion U.S. dollars, the examination of antibiotic resistance on both local and global scales has become essential. Antibiotic resistance is a multidimensional problem that connects water professionals with many scientists from different professions. In this review, we provide the big picture to the researchers venturing into this topic with respect to wastewater treatment and water safety, focusing on two aspects: antibiotics and antibiotic resistance and how they are intertwined. The story opens with the history of antibiotics, followed by their classes, modes of action and main bacterial targets, uses in clinical settings and agriculture, and presence in wastewater and the environment. The section about antibiotic resistance starts with its definition in clinical and environmental settings, followed by types and means of genetic transfer, prioritization, environmental risk and the current regulation framework, and the fate of antibiotic resistant bacteria and their genes throughout the wastewater treatment plant. The review ends with recommendations that should help water professionals in making educated decisions in research pursuits and avoiding common pitfalls when embarking on a journey of antibiotic resistance.