Updated on 5 June 2018

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 sites
  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 influences 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 resistance issues.

20180605 Factor correlations (Spearman's)

 Polluted sites FoodResistanceWHO essential drugOn-line demandThis Index
Polluted sites 1.000.600.460.440.460.82
Food 1.000.370.320.250.60
Resistance1.000.720.810.78
WHO essential drug1.000.650.78
On-line demand1.000.67
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 36 locations globally;
  • 88 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 50 thousand posts on-line, that request or offer this drug.

The List

antibiotic index
Tetracycline

791

Ampicillin

614

Ciprofloxacin

599

Chloramphenicol

591

Sulfamethoxazole

518

Erythromycin

515

Trimethoprim

507

Ofloxacin

438

Clindamycin

408

Sulfadimidine or Sulfamethazine

398

Amoxicillin

394

Doxycycline

345

Sulfadiazine

307

Oxytetracycline

284

Norfloxacin

273

Metronidazole

272

Piperacillin

228

Chlortetracycline

222

Sulfadoxin

215

Cefotaxime

213

Cephalexin

210

Clarithromycin

199

Cefazolin

198

Enrofloxacin

197

Azithromycin

164

Levofloxacin

153

Roxithromycin

148

Lincomycin

129

Moxifloxacin

115

Nalidixic acid

110

Sulfadimethoxine

106

Tylosin

88

Sulfaquinoxaline

86

Sulfathiazole

79

Sulfamonomethoxine

70

Cefuroxime

65

Sulfachloropyridazine

58

Florfenicol

57

Sulfapyridine

57

Monensin

53

Sulfameter

49

Sulfaclozine

45

Sarafloxacin

43

Pefloxacin

43

Enoxacin

42

Gatifloxacin

41

Sulfisoxazole

40

Flumequine

39

Lomefloxacin

39

Oxolinic acid

38

Danofloxacin

38

Thiamphenicol

37

Spiramycin

37

Marbofloxacin

35

Sparfloxacin

35

Olaquindox

33

Sulfamethizole

33

Sulfamerazine

32

Sulfacetamide

32

Difloxacin

31

Fleroxacin

30

Oleandomycin

30

Pipemidic acid

30

Narasin

28

Josamycin

28

Dimetridazole

26

Tiamulin

25

Leucomycin

24

Sulfamethoxydiazine

22

Enfloxacin

22

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.