Environmental health and preventive medicine · 2026
Occurrence of antibacterials, antivirals, and anti-inflammatory pharmaceuticals for COVID-19 treatment as emerging contaminants in the Chinese freshwater environment before, during and after the pandemic: the need for dynamic eco-pharmacovigilance.
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Ma Sijia, Chen Hongxia, Wang Jun
Аннотация
BACKGROUND: Global epidemic diseases such as COVID-19 have driven both the excessive use of pharmaceuticals and shifts in their usage spectrum. Consequently, the profile of pharmaceuticals in the environment (PiE) may undergo dynamic temporal changes, posing a significant challenge to eco-pharmacovigilance (EPV), a specialized branch of pharmacovigilance focused on detecting, evaluating, understanding, and preventing the adverse environmental effects of pharmaceuticals.
METHODS: Based on data extracted from 89 studies published between 2014 and 2025, this review conducts a focused comparison of the occurrence patterns of 43 selected typical anti-COVID-19 drugs (20 antibacterials, 11 antivirals, and 12 anti-inflammatory pharmaceuticals) as contaminants in distinct regions across China's seven major river basins before, during, and after the pandemic. The need of dynamic EPV was then analyzed.
RESULTS: Before the COVID-19 outbreak, erythromycin, ampicillin, roxithromycin, and acetaminophen dominated the PiE profile in terms of reported maximum residual concentrations; during the pandemic lockdown, ciprofloxacin, ofloxacin, azithromycin, and ketoprofen were identified as the top-priority anti-COVID-19 PiE; after the pandemic, azithromycin, norfloxacin, ofloxacin, ciprofloxacin, and roxithromycin remained the dominant PiE. Residual levels of individual PiE at the same location varied noticeably across the three periods.
CONCLUSIONS: Results revealed highly distinct regional and temporal variations in surface freshwater pollution by these COVID-19-associated PiE across the three periods, with no consistent regularity observed, thereby further highlighting the necessity of implementing EPV in a "dynamic" manner. Drawing on the framework of dynamic pharmacovigilance, the implementation of dynamic EPV can be promoted by establishing a dynamic watch-list mechanism, clarifying stakeholder roles, and advancing supportive policies and technological platforms, so as to enable adaptive interventions for the timely management of event-driven pharmaceutical pollution.
METHODS: Based on data extracted from 89 studies published between 2014 and 2025, this review conducts a focused comparison of the occurrence patterns of 43 selected typical anti-COVID-19 drugs (20 antibacterials, 11 antivirals, and 12 anti-inflammatory pharmaceuticals) as contaminants in distinct regions across China's seven major river basins before, during, and after the pandemic. The need of dynamic EPV was then analyzed.
RESULTS: Before the COVID-19 outbreak, erythromycin, ampicillin, roxithromycin, and acetaminophen dominated the PiE profile in terms of reported maximum residual concentrations; during the pandemic lockdown, ciprofloxacin, ofloxacin, azithromycin, and ketoprofen were identified as the top-priority anti-COVID-19 PiE; after the pandemic, azithromycin, norfloxacin, ofloxacin, ciprofloxacin, and roxithromycin remained the dominant PiE. Residual levels of individual PiE at the same location varied noticeably across the three periods.
CONCLUSIONS: Results revealed highly distinct regional and temporal variations in surface freshwater pollution by these COVID-19-associated PiE across the three periods, with no consistent regularity observed, thereby further highlighting the necessity of implementing EPV in a "dynamic" manner. Drawing on the framework of dynamic pharmacovigilance, the implementation of dynamic EPV can be promoted by establishing a dynamic watch-list mechanism, clarifying stakeholder roles, and advancing supportive policies and technological platforms, so as to enable adaptive interventions for the timely management of event-driven pharmaceutical pollution.