Updated on 13 May 2019

The Index

For each antibiotic that pollutes the environment, this Index estimates its impact on consumer safety from none (1) to severe (1000). It takes the following 5 factors into account:

  1. Polluted site
  2. Residue in food
  3. Resistance against this antibiotic
  4. Placed on the WHO Model List of Essential Medicines
  5. Incorrect use: Public Demand to obtain this antibiotic without prescription on the web

Correlations of these 5 factors as well as this Index are provided in the table below.

High correlations might be a first indication that one factor is dependent on the other.

The high correlation between On-line demand and Resistance is an intriguing one, pointing at a market element that gets little attention in addressing antibiotic usage and the approach towards antibiotic resistance.

20190513 Factor correlations (Spearman's)

 Polluted sites FoodResistanceWHO essential drugOn-line demandThis Index
Polluted sites 1.000.540.430.430.480.77
Food 1.000.310.220.210.61
Resistance1.000.650.860.72
WHO essential drug1.000.650.77
On-line demand1.000.69
This Index1.00

What can I do with the Index?

Consumers

Find out the Index for your antibiotic. If it is high, this drug is likely on its way out, and the world may loose an important cure for your disease, unless we reduce it’s usage and pollution levels in the pharmaceutical, agricultural and (health-)care industries.

Follow your physician’s advice, but don’t forget to confirm that:

a/ without antibiotics, you would be at risk;
b/ without antibiotics, you will not get better.

Dispose of the remains responsibly and never keep antibiotics to self-medicate.

Professionals

Health care providers and veterinarians

Use the Index as an entry point for improving the sustainable use of antibiotics in your practice and to inform your patients and clients on risks associated to irrational use of antibiotics.

Public Health professionals and NGOs

Your policy advice and/or implementation could benefit from data behind the Index, which contain more detailed insights of the factors involved. Please get in touch via LinkedIn to see how we can support you.

My antibiotic is not on the list. What does it mean?

SquaredAnt looks for antibiotics in the environment. Only those that are identified are indexed. For now, we only use academic publications as a resource. If your antibiotic is not on the list, it means that no publications have been processed that mention this antibiotic.

Leader of the pack

Currently, Tetracycline has the highest Index. SquaredAnt has found

  • evidence for pollution on 38 locations globally;
  • 115 publications that link to pollution of food;
  • nearly 16 thousand publications that link to resistance;
  • it is defined as an essential medicine by the WHO;
  • over 900 thousand posts on-line, that request or offer this drug.

The List

antibiotic_agentindex
Tetracycline800
Ciprofloxacin717
Ampicillin637
Chloramphenicol583
Trimethoprim522
Sulfamethoxazole515
Erythromycin460
Amoxicillin451
Sulfadimidine or Sulfamethazine427
Ofloxacin403
Doxycycline355
Sulfadiazine329
Oxytetracycline323
Norfloxacin306
Clindamycin303
Metronidazole287
Enrofloxacin262
Chlortetracycline241
Piperacillin232
Cephalexin223
Clarithromycin203
Cefazolin202
Azithromycin193
Sulfadoxin192
Cefotaxime191
Levofloxacin157
Roxithromycin155
Nalidixic acid121
Tylosin121
Lincomycin121
Sulfadimethoxine115
Moxifloxacin115
Sulfaquinoxaline93
Sulfathiazole90
Flumequine81
Florfenicol79
Sulfamonomethoxine74
Cefuroxime72
Sarafloxacin68
Sulfapyridine66
Danofloxacin63
Oxolinic acid62
Thiamphenicol59
Sulfachloropyridazine56
Sulfameter52
Lomefloxacin52
Tilmicosin52
Sulfamerazine52
Monensin51
Spiramycin51
Marbofloxacin49
Difloxacin48
Sulfisoxazole47
Sulfaclozine45
Pefloxacin44
Gatifloxacin42
Enoxacin40
Olaquindox39
Oleandomycin37
Sulfamethizole36
Sulfacetamide35
Fleroxacin35
Sparfloxacin35
Josamycin35
Dimetridazole30
Pipemidic acid30
Tiamulin29
Kitasamycin29
Narasin28
Sulfamethoxydiazine25
Leucomycin22

Disclaimer
The Antibiotics Pollution Index is an initiative of SquaredAnt and intended to generate awareness on the risks of uncontrolled exposure to antibiotics. SquaredAnt does not accept responsibility for any damage through the use or interpretation of the Index, and no rights may be derived from its contents.

History
Click here to browse the preceding version of this index.