When antibiotics are overused or improperly discarded, they can contribute to pollution and the development of antibiotic-resistant bacteria.
Preeti Jaggi, M.D.
Director of Antimicrobial Stewardship, Children’s Healthcare of Atlanta; Member, Society for Healthcare Epidemiology of America (SHEA)
Emily Sydnor Spivak, M.D., M.H.S.
Medical Director, Antimicrobial Stewardship Programs, University of Utah School Hospital; Member, Society for Healthcare Epidemiology of America (SHEA)
The medical community overwhelmingly agrees that climate change poses a direct threat to public health, and urgent action is needed to mitigate its impact. Alongside climate change, the World Health Organization (WHO) has identified antibiotic resistance as one of the top global health threats.
Antibiotics are essential for treating bacterial infections, but their overuse and improper disposal contribute to environmental contamination and the spread of antimicrobial resistance. As resistant bacteria become more common, infections become harder to treat, putting lives at risk and straining healthcare systems.
Addressing antibiotic overuse is not just a medical issue — it is also an environmental one, requiring greater awareness and action. Healthcare institutions and professional societies like the Society for Healthcare Epidemiology of America (SHEA) have a responsibility to lead efforts in reducing unnecessary antibiotic use and improving disposal practices to mitigate these risks.
How antibiotics contribute to environmental waste
Antibiotics make their way into the environment through multiple channels, including pharmaceutical manufacturing, hospital wastewater, and improper disposal by patients and healthcare facilities. Research is increasingly revealing the environmental toll of antibiotic overuse and waste. For example, in 2022, unnecessary outpatient antibiotic prescriptions in the United States generated an estimated 1,887 metric tons of CO₂-equivalent emissions — the same as driving a gasoline-powered car 194 times around the Earth’s equator.
Additionally, a study found that over 90% of community pharmacists reported dispensing extra liquid amoxicillin beyond what was needed due to packaging constraints and prescribing practices. Much of this excess medication ends up in the trash or is poured down the drain, allowing antibiotics to seep into water systems, where they contribute to contamination and the development of antibiotic-resistant bacteria. These findings are part of a growing body of research showing how antibiotic misuse not only threatens public health but also poses a significant risk to the environment.
Solutions for a sustainable approach to antibiotic use
A growing number of strategies are being implemented to help reduce the environmental impact of antibiotics. One approach is ensuring that antibiotics are prescribed only when necessary, as reducing unnecessary prescriptions helps limit the amount of medication that enters the environment. Proper disposal methods also help minimize contamination and reduce the amount of waste generated. Instead of flushing unused antibiotics or throwing them in the household trash, many pharmacies and healthcare facilities offer take-back programs for safe disposal.
Another area of focus is wastewater treatment, as many healthcare institutions and policymakers are exploring advanced filtration technologies to remove pharmaceutical contaminants before they reach water sources. Additionally, experts in infectious diseases, environmental science, and public health are working together to develop sustainable strategies that balance effective antibiotic use with environmental protection. These combined efforts aim to reduce antibiotic waste and its potential impact on ecosystems while maintaining access to necessary medical treatments.
Public awareness and education are key
Many people may not realize that the way antibiotics are used and disposed of can have lasting effects on the environment. When antibiotics are overused or improperly discarded, they can contribute to pollution and the development of antibiotic-resistant bacteria, making infections harder to treat in the future. Research continues to highlight the importance of reducing unnecessary antibiotic use and ensuring proper disposal methods to limit their impact on ecosystems.
Efforts are underway to promote responsible antibiotic use while also considering environmental sustainability. Organizations like SHEA are working to promote responsible antibiotic use and reduce environmental harm. By increasing awareness, individuals and communities can help protect both public health and the planet.
