A Call to Action: An Evidence Review on Pharmaceutical Disposal in the Context of Antimicrobial Resistance in Canada

There is also agreement on the need to work towards a better understanding of the contribution of environmental factors to AMR, and opportunities to mitigate the risk of AMR in the environment (9,19). [...] Methods The aim of this review is to understand how pharmaceuticals in the environment influence antimicrobial resistance, the scope and nature of pharmaceutical disposal programs in Canada, and to provide examples of such programs that could be adopted for the Canadian context. [...] Prescription Drug Disposal in Canada | 7 Antibiotics in the Environment According to the Public Health Agency of Canada’s report on the Canadian Antimicrobial Resistance Surveillance System (CARSS), in 2016 about 92% of the total antimicrobials prescribed for human use were dispensed in the community and the remaining 8% was used in hospitals. [...] In 1992, the Canadian Council of Ministers of the Environment developed the national standard guidelines for the management of biomedical waste in the environment to streamline the different waste management and disposal practices among provinces and territories. [...] These include the KNAPPE project (2007 – 2008) studying the evidence on pharmaceutical in the aquatic environment; the CYTOTHREAT project (2011 – 2014) examining the fate and effects of cytostatic pharmaceuticals in freshwater organisms and in vitro cells and; and the PHARMAS project (2011 – 2014) investigating the environmental and health risk of antibiotics and anticancer drugs in the environmen.