Determination of 35 antibiotics and four β-receptor agonists in teenagers and analysis of exposure status

Abstract

Antibiotics are mainly used for disease treatment and prevention, and β-receptor agonists are mainly used in the clinical treatment of respiratory diseases. Both types of drugs are also widely used in animal husbandry and aquaculture to promote animal growth and prevent disease. These drugs enter the human body through many routes and cause harm to human health. Teenagers are in a critical period of growth and development, and long-term antibiotic exposure may have adverse effects on their bodies. In this study, 442 teenagers aged 11-15 years were recruited from a middle school to investigate the body burden of various antibiotics and β-receptor agonists. The seven categories of antibiotics, including five macrolides, four tetracyclines, 10 quinolones, 11 sulfonamides, three β-lactams, one quinoxaline, and one lincosamide, and four β-receptor agonists were determined by isotope dilution and solid phase extraction coupled with ultra performance liquid chromatography-tandem mass spectrometry. Analyte levels were corrected using urine creatinine, and detection rates were used for data analysis. Pearson's chi-squared test was used to analyze the correlations between detection rate and gender, age, or body mass index (BMI). Logistic regression was used to evaluate the correlation between detection rate and different groups after adjusting for confounding factors. The results showed that 397 teenagers had at least one antibiotic or β-receptor agonist in their urine, with a total detection rate of 89.8%. A total of 29 antibiotics and β-receptor agonists were detected, and the detection rate of each compound ranged from 0.2% to 59.0%. Doxycycline, oxytetracycline, and azithromycin were the top three drugs with the highest detection rates (59.0%, 56.1%, and 34.6%, respectively). Tetracyclines and macrolides were the two antibiotic categories detected most often, with detection rates of 81.9% and 42.3%, respectively. Among the antibiotics investigated, preferred veterinary antibiotics (PVAs) had the highest detection rate (85.1%), followed by human antibiotics (HAs) (41.0%). The overall detection rate of β-receptor agonists was 2.7%. Statistical analysis showed that the male was prone to be exposed to tetracycline antibiotics (odds ratio (OR)=2.17). The detection rates of macrolides differed among the different age groups and were higher in those aged 12-13 years than in those aged 11 years. As the BMI of the teenagers increased, the detection rate of macrolides gradually increased. After adjusting for age and gender, teenagers with obesity were found to be 2.35 times more likely to be exposed to macrolides than those with a normal weight. The findings suggest that teenagers are generally exposed to low levels of antibiotics, that food and the environment may be the main sources of antibiotic exposure in teenagers, and that macrolide exposure may be associated with adolescent obesity.