. 2023 Nov 17;5(46):1038–1044. doi: 10.46234/ccdcw2023.195

Table 2. Some typical successful cases of AMR control from antibiotic production wastewater in antibiotic manufacturing in China.

Areas	Description	Source or impacts
Abbreviation: CPEA=China Pharmaceutical Enterprises Association; CPIA=China Pharmaceutical Industry Association;SOA=synchronized oxidation-adsorption, MVR=mechanical vapor recompression, API=active pharmaceutical ingredient, PNECs=Predicted No-Effect Concentrations, ARGs=antibiotic resistance genes.
Engineering application	Pretreatment (enhanced hydrolysis), biological treatment and advanced treatment (low-cost SOA technology) were successfully applied in full-scale pharmaceutical wastewater treatment plants in Hebei Province and Jiangsu Province in China.	Pretreatment of antibiotic production wastewater to remove antibacterial potency is the best way to control the development of ARGs, as well as the above successful cases, has been subsumed in “Technical brief on water, sanitation, hygiene and wastewater management to prevent infections and reduce the spread of antimicrobial resistance” (2020) [ISBN (WHO) 978-92-4-000641-6] and Ministry of Ecology and Environment of China standard (HJ 1305-2023).
Engineering application	Technique integration including the pretreatment (e.g., electrochemical oxidation, iron-carbon microelectrode, MVR), biological treatment, advanced treatment (e.g., ozone oxidation) or zero emission (e.g., MVR+ special membrane) were applied in some plants in China.	Some cases were included in the Compilation of Excellent Cases Pharmaceutical Industry Environment, Health and Safety (EHS) (2019–2021) by CPEA (http://www.cpema.org/).
Environmental management	A chapter of “Synergistic control of antibiotics, resistance genes and conventional pollutants in pharmaceutical wastewater”.	“Bluebook of pharmaceutical Industry” (ISBN 9787520170635) was published by CPIA in 2020.
	API management and PNECs in pharmaceutical wastewater.	Pharmaceutical Industry Environment, Health and Safety (EHS) Guide (2020) by CPEA (http://www.cpema.org/).
	Three standards for determining erythromycin, cephalosporin and penicillin in antibiotic fermentation residue, raw fertilizer material, crop, and related environments.	CPIA (TPIAC00001-2021, TPIAC00002-2021, and TPIAC00003-2021).
	A series of available techniques including the enhanced hydrolysis pretreatment for API removal were summarized in this standard, which is an important criterion on pollution (including antibiotics) control in pharmaceutical industry.	Standard by Ministry of Ecology and Environment of China: “Guideline on available techniques of pollution prevention and control for pharmaceutical industry (fermentation, chemical synthesis, extraction) and preparation categories” (HJ 1305-2023).