State-of-the-Art Reviews
Sep 10, 2024

Cephalosporin Containment Management Strategies from Drug Manufacturing to Control Antibiotic Resistance in South Asia

Publication: Journal of Hazardous, Toxic, and Radioactive Waste
Volume 29, Issue 1

Abstract

Antibiotics, especially cephalosporins, have been identified as immense environmental pollutants for the generation of antibiotic-resistant gene and antibiotic-resistant bacteria due to its indiscriminate usage, enormous production and consumption, highest prescription, and longtime existence as bioactive in the environment. There are multiple sources identified for this environmental pollution and drug manufacturing units are top of the list because other sources of contamination release a lower amount of drugs through excretion but direct discharges to the environment from drug manufacturing possess a huge possibility to exert a selective pressure for antibiotic resistance. There are multiple ways of discharging environmental pollutants from a drug manufacturing unit. Man, material, and machine are all responsible for contaminating the environment from a drug manufacturing unit, which can lead to the risk of resistance to organisms, especially bacteria present in the environment, and can produce multiresistant bacteria. Some recent initiatives for degradation or removal have been published within the last couple of years featuring various aspects of antibiotics. However, a complete methodology for controlling and removal of antibiotics, especially cephalosporin antibiotic contaminants, from a manufacturing plant is still unavailable, and thus affects the management of cephalosporin discharges. This review highlights the potential sources of contamination from a cephalosporin manufacturing unit, current industrial practices, and the possible management procedure including methodologies for removal of these contaminants before exposure to the environment to control antibiotic resistance.

Get full access to this article

View all available purchase options and get full access to this article.

Data Availability Statement

No data, models, or code were generated or used during the study.

Acknowledgments

The first author is obliged for a Ph.D. fellowship to the Department of Pharmacy, Jahangirnagar University, Dhaka, Bangladesh. The authors would like to acknowledge the editor and reviewers for their critical and constructive remarks, which helped in improving the quality of the manuscript.

References

Access to Medicine Foundation. 2020. “Antimicrobial resistance benchmark 2020.” Accessed March 21, 2023. https://accesstomedicinefoundation.org/resource/2021-antimicrobial-resistance-benchmark.
Afreen, S., and S. Paul. 2014. “Pharmaceutical waste water treatment & related economic aspects for reuse in the context of Bangladesh.” J. Chem. Eng. 27 (2): 46–49. https://doi.org/10.3329/jce.v27i2.17801.
Ahmad, A., I. Patel, M. U. Khan, and Z. u.-d. Babar. 2017. “Pharmaceutical waste and antimicrobial resistance.” Lancet Infect. Dis. 17 (6): 578–579. https://doi.org/10.1016/S1473-3099(17)30268-2.
Ajonina, C., C. Buzie, R. H. Rubiandini, and R. Otterpohl. 2015. “Microbial pathogens in wastewater treatment plants (WWTP) in Hamburg.” J. Toxicol. Environ. Health Part A 78 (6): 381–387. https://doi.org/10.1080/15287394.2014.989626.
Alouache, S., V. Estepa, Y. Messai, E. Ruiz, C. Torres, and R. Bakour. 2014. “Characterization of ESBLs and associated quinolone resistance in Escherichia coli and Klebsiella pneumoniae isolates from an urban wastewater treatment plant in Algeria.” Microb. Drug Resist. 20 (1): 30–38. https://doi.org/10.1089/mdr.2012.0264.
Anastasi, E. M., B. Matthews, H. M. Stratton, and M. Katouli. 2012. “Pathogenic Escherichia coli found in sewage treatment plants and environmental waters.” Appl. Environ. Microbiol. 78 (16): 5536–5541. https://doi.org/10.1128/AEM.00657-12.
Anjum, M., N. H. Al-Makishah, and M. A. Barakat. 2016. “Wastewater sludge stabilization using pre-treatment methods.” Process Saf. Environ. Prot. 102: 615–632. https://doi.org/10.1016/j.psep.2016.05.022.
Ara, R. 2013. “Comparative exploration of ETP water of pharmaceutical companies in Bangladesh.” Accessed March 21, 2023. http://hdl.handle.net/10361/10326.
Casals-Pascual, C., A. Vergara, and J. Vila. 2018. “Intestinal microbiota and antibiotic resistance: Perspectives and solutions.” Hum. Microbiome J. 9: 11–15. https://doi.org/10.1016/j.humic.2018.05.002.
CDC (Centers for Disease Control and Prevention). 2019. “Guidelines for environmental infection control in health-care facilities.” Accessed August 22, 2024. https://www.cdc.gov/infectioncontrol/pdf/guidelines/environmental-guidelines-P.pdf.
CDSCO. 2017. “Rational use of antibiotics for limiting antimicrobial resistance.” Central Drugs Standard Control Organization (CDSCO). Accessed March 21, 2023. https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadPublic_NoticesFiles/Combine.pdf.
Chouduri, A. U., M. Biswas, M. U. Haque, M. S. I. Arman, N. Uddin, N. Kona, R. Akter, and A. Haque. 2018. “Cephalosporin- 3 g, highly prescribed antibiotic to outpatients in Rajshahi, Bangladesh: Prescription errors, carelessness, irrational uses are the triggering causes of antibiotic resistance.” J. Appl. Pharm. Sci. 8 (6): 105–112. https://doi.org/10.7324/JAPS.2018.8614.
CIDRAP-ASP (Center for Infectious Disease Research and Policy Antimicrobial Stewardship Project). 2022. The limit of limits: India’s hurdles in regulating antimicrobial pollution.” Report. Accessed March 22, 2023. https://www.cidrap.umn.edu/sites/default/files/the_limit_of_limits_indias_hurdles_in_regulating_antimicrobial_pollution.pdf.
Cyprowski, M., A. Stobnicka-Kupiec, A. Ławniczek-Wałczyk, A. Bakal-Kijek, M. Gołofit-Szymczak, and R. L. Górny. 2018. “Anaerobic bacteria in wastewater treatment plant.” Int. Arch. Occup. Environ. Health 91: 571–579. https://doi.org/10.1007/s00420-018-1307-6.
Das, N., J. Madhavan, A. Selvi, and D. Das. 2019. “An overview of cephalosporin antibiotics as emerging contaminants: A serious environmental concern.” 3 Biotech. 9: 1–14. https://doi.org/10.1007/s13205-019-1766-9.
DGDA (Directorate General of Drug Administration). 2023. “Allopathic drug database, displayed date.” Accessed March 20, 2023. https://dgdagov.info/index.php/registered-products/allopathic.
ECR (Environment Conservation Rules). 1997. “Published in the Bangladesh gazette, extra-ordinary issue of 28-8-1997 and amended by notifications S.R.O 29-Law/2002, S.R.O 234-Law/2002 and S.R.O 88-Law/2003.” Accessed March 21, 2023. https://faolex.fao.org/docs/pdf/bgd19918.pdf.
EMEA (European Medicines Agency). 2020. “ICH Q7: Good manufacturing practice of active pharmaceutical ingredients.” Accessed March 22, 2023. https://www.ema.europa.eu/en/documents/scientific-guideline/ich-q-7-good-manufacturing-practice-active-pharmaceutical-ingredients-step-5_en.pdf.
EPR (Environment Protection Act). 1986. “Environment (Protection) Rules, India.” Accessed March 21, 2023. https://faolex.fao.org/docs/pdf/ind8236.pdf.
EU GMP 2022. “The rules governing medicinal products in the European Union Volume 4 EU guidelines for good manufacturing practice for medicinal products for human and veterinary use.” Accessed March 12, 2023. https://health.ec.europa.eu/system/files/2022-08/20220825_gmp-an1_en_0.pdf.
FDA (Food and Drug Administration). 2023. “Part 211: Current good manufacturing practice of finished pharmaceuticals.” 21 CFR. Accessed March 22, 2023. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=211.
Gadipelly, C., A. Pérez-González, G. D. Yadav, I. Ortiz, R. Ibáñez, V. K. Rathod, and K. V. Marathe. 2014. “Pharmaceutical industry wastewater: Review of the technologies for water treatment and reuse.” Ind. Eng. Chem. Res. 53 (29): 11571–11592. https://doi.org/10.1021/ie501210j.
Gangathraprabhu, B., S. Geethanjali, N. Baskaran, and M. Murugan. 2019. “Multidrug-resistant salmonella: A raising calamity.” Int. J. Res. Pharm. Sci. 10 (1): 318–327.
Gaze, W., and M. Depledge. 2017. “Antimicrobial resistance: Investigating the environmental dimension-frontiers 2017: Emerging issues of environmental concern chapter 1.” Accessed March 22, 2023. https://wedocs.unep.org/bitstream/handle/20.500.11822/22263/Frontiers_2017_CH1_EN.pdf?sequence=1&isAllowed=y.
Gelband, H., P. M. Miller, S. Pant, S. Gandra, J. Levinson, D. Barter, A. White, and R. Laxminarayan. 2015. “The state of the world’s antibiotics 2015.” Wound Healing South. Afr. 8 (2): 30–34.
Gros, M., M. Petrović, and D. Barceló. 2006. “Multi-residue analytical methods using LC-tandem MS for the determination of pharmaceuticals in environmental and wastewater samples: A review.” Anal. Bioanal.Chem. 386 (4): 941–952. https://doi.org/10.1007/s00216-006-0586-z.
Hoque, R., S. M. Ahmed, N. Naher, M. A. Islam, E. K. Rousham, B. Z. Islam, and S. Hassan. 2020. “Tackling antimicrobial resistance in Bangladesh: A scoping review of policy and practice in human, animal and environment sectors.” PLoS One 15 (1): e0227947. https://doi.org/10.1371/journal.pone.0227947.
Hue, T. T. T., D. C. Son, N. T. L. Anh, T. K. Phong, and K. Hiramatsu. 2014. “A simple and rapid method to measure residue of cefexime–A cephalosporin antibiotic in the wastewater of pharmaceutical production plant.” J. Fac. Agric. 59: 169–175. https://doi.org/10.5109/1434408.
Jassal, P. S., D. Kaur, M. Kaur, and D. Sharma. 2023. “Level of antibiotic contamination in the major river systems: A review on South Asian countries perspective.” J. Appl. Pharm. Sci. 13 (6): 010–017. https://doi.org/10.7324/JAPS.2023.56748.
Kothari, R. D., A. Barde, H. Bhide, T. Deshpande, N. S. Narkar, and A. V. Tilak. 2021. “Use of cephalosporin type antimicrobials in infection wards in tertiary hospital in west India.” J. Pharm. Res. Int. 33 (43B): 510–517. https://doi.org/10.9734/jpri/2021/v33i43B32582.
Kotwani, A., J. Joshi, and D. Kaloni. 2021. “Pharmaceutical effluent: A critical link in the interconnected ecosystem promoting antimicrobial resistance.” Environ. Sci. Pollut. Res. 28 (25): 32111–32124. https://doi.org/10.1007%2Fs11356-021-14178-w.
Kotwani, A., A. Kapur, M. Chauhan, and S. Gandra. 2023. “Treatment and disposal practices of pharmaceutical effluent containing potential antibiotic residues in two states in India and perceptions of various stakeholders on contribution of pharmaceutical effluent to antimicrobial resistance: A qualitative study.” J. Pharm. Policy Pract. 16 (1): 59. https://doi.org/10.1186/s40545-023-00562-z.
Kumar, A., and D. Pal. 2018. “Antibiotic resistance and wastewater: Correlation, impact and critical human health challenges.” J. Environ. Chem. Eng. 6 (1): 52–58. https://doi.org/10.1016/j.jece.2017.11.059.
Larsson, D. G. J. 2014. “Pollution from drug manufacturing: Review and perspectives.” Phil. Trans. R. Soc. B 369 (1656): 20130571. https://doi.org/10.1098/rstb.2013.0571.
Larsson, D. G. J., C. de Pedro, and N. Paxeus. 2007. “Effluent from drug manufactures contains extremely high levels of pharmaceuticals.” J. Hazard. Mater. 148 (3): 751–755. https://doi.org/10.1016/j.jhazmat.2007.07.008.
Laxminarayan, R., and R. R. Chaudhury. 2016. “Antibiotic resistance in India: Drivers and opportunities for action.” PLoS Med. 13 (3): e1001974. https://doi.org/10.1371/journal.pmed.1001974.
Levy, S. B. 2002. “Factors impacting on the problem of antibiotic resistance.” J. Antimicrob. Chemother. 49 (1): 25–30. https://doi.org/10.1093/jac/49.1.25.
Lin, A. Y.-C., T.-H. Yu, and C.-F. Lin. 2008. “Pharmaceutical contamination in residential, industrial, and agricultural waste streams: Risk to aqueous environments in Taiwan.” Chemosphere 74 (1): 131–141. https://doi.org/10.1016/j.chemosphere.2008.08.027.
Maal, K. B., A. S. Delfan, and S. Salmanizadeh. 2014. “Isolation and identification of klebsiella pneumonia and klebsiella oxytoca bacteriophages and their application in wastewater treatment and coliform's phage therapy.” Res. J. Environ. Sci. 8 (3): 123–133. https://doi.org/10.3923/rjes.2014.123.133.
Masood, A. S., M. S. Ali, M. S. Manzar, N. A. Khan, and A. H. Khan. 2023. “The treatment of pharmaceutical wastewater.” In Innovative technologies and the adaptation of treatment systems, edited by A. H. Khan, N. A. Khan, M. Naushad, and H. A. Aziz, 19–52. Amsterdam, The Netherlands: Elsevier.
MoEF&CC (Indian Ministry of Environment, Forestry and Climate Change). 2020. “Environment (protection) amendment rules, 2019.” Accessed August 22, 2024. https://sansad.in/getFile/loksabhaquestions/annex/174/AU1431.pdf?source=pqals.
MoEF&CC (Indian Ministry of Environment, Forestry and Climate Change). 2021. “Environment (protection) second amendment rules, 2021.” Accessed August 22, 2024. https://cpcb.nic.in/uploads/Industry-Specific-Standards/Effluent/73-pharmaceuticals.pdf.
MOHF (Ministry of Health & Family). 2022. “Guideline on Antimicrobial Consumption (AMC) surveillance in Bangladesh, Rev: 01, By DGDA on July 2022.” Accessed March 22, 2023. https://dgdagov.info/index.php/information-center/guidance-documents/2340-amc-surveillance-guideline-for-comments/file.
MOHFW (Ministry of Health & Family Welfare). 2017a. “National action plan-antimicrobial resistance containment in Bangladesh.” Accessed March 12, 2023. https://cdn.who.int/media/docs/default-source/antimicrobial-resistance/amr-spc-npm/nap-library/antimicrobial-resistance-containment-in-bangladesh-2017-2022.pdf?sfvrsn=bfa46b_3&download=true.
MOHFW (Ministry of Health & Family Welfare). 2017b. “National action plan on antimicrobial resistance, 2017-2021, India.” Accessed August 22, 2024. https://www.ncdc.gov.in/WriteReadData/l892s/File645.pdf.
MOHFW (Ministry of Health & Family Welfare). 2019. “National anti-microbial stewardship quality improvement (QI) framework; By quality improvement secretariat.” Accessed March 12, 2023. http://qis.gov.bd/wp-content/uploads/2019/05/National-Anti-Microbial-Stewardship-AMS-QI-Framework.pdf.
Mutanda, L. N., M. Rahman Khan, N. Atiq, and A. K. Golam Kibriya. 1983. “Antibiotic-resistant enterobacteria in river and pond water in Dhaka.” Indian J. Med. Res. 77: 423–426.
Nawar, S., M. T. Rashid, A. Ahmed, M. M. Hossain, and A. B. Afzal. 2021. “A study of prevalence and pathogenic activity of bacteria in the air of Dhaka City and their antimicrobial resistance pattern.” Am. J. Mol. Biol. 11 (2): 51. https://doi.org/10.4236/ajmb.2021.112005.
News Medical Life Science. 2020. “Study: Bangladesh’s surface waters have high levels of antibiotic residues, chemicals.” Reviewed by: Emily Henderson. Accessed April 3, 2023. https://www.news-medical.net/news/20200411/Study-Bangladeshe28099s-surface-waters-high-levels-of-antibiotic-residues-chemicals.aspx.
Numberger, D., L. Ganzert, L. Zoccarato, K. Mühldorfer, S. Sauer, H.-P. Grossart, and A. D. Greenwood. 2019. “Characterization of bacterial communities in wastewater with enhanced taxonomic resolution by full-length 16S rRNA sequencing.” Sci. Rep. 9 (1): 9673. https://doi.org/10.1038/s41598-019-46015-z.
Patil, P. N., and S. Jacob. 2012. “HPLC analysis of cephalosporins and study of different analytical parameters.” Int. J. Pharm. Sci. Res. 3 (1): 1–4. https://doi.org/10.13040/IJPSR.0975-8232.3(1).1-14.
Peterson, E., and P. Kaur. 2018. “Antibiotic resistance mechanisms in bacteria: Relationships between resistance determinants of antibiotic producers, environmental bacteria, and clinical pathogens.” Front. Microbiol. 9: 2928. https://doi.org/10.3389/fmicb.2018.02928.
Pharma Industry of Bangladesh. 2019. “Pharmaceutical industry of Bangladesh.” 3rd ed. Accessed July 28, 2019. https://www.arx.cfa/∼/media/2A85F9B2CEAB43CFAF325AB54F3EF404.ashx.
Polianciuc, S. I., A. E. Gurzău, B. Kiss, M. G. Ştefan, and F. Loghin. 2015. “Antibiotics in the environment: Causes and consequences.” Med. Pharm. Rep. 93 (3): 231. https://doi.org/ 10.15386/mpr-1742.
Rayan, R. A. 2023. “Pharmaceutical effluent evokes superbugs in the environment: A call to action.” Biosaf. Health 5 (06): 363–371. https://doi.org/10.1016/j.bsheal.2023.10.005.
Ribeiro, A. R., B. Sures, and T. C. Schmidt. 2018. “Cephalosporin antibiotics in the aquatic environment: A critical review of occurrence, fate, ecotoxicity and removal technologies.” Environ. Pollut. 241: 1153–1166. https://doi.org/10.1016/j.envpol.2018.06.040.
Schjørring, S., and K. A. Krogfelt. 2011. “Assessment of bacterial antibiotic resistance transfer in the gut.” Int. J. Microbiol. 2011: 1–10. https://doi.org/10.1155/2011/312956.
Sharfin, S. 2016. “Isolation, characterization, identification and antimicrobial susceptibility testing of bacteria associated with pharmaceutical waste water treatment.” Master of Science thesis, Dept. of Mathematics and Natural Sciences, BRAC Univ.
Sim, W.-J., J.-W. Lee, and J.-E. Oh. 2010. “Occurrence and fate of pharmaceuticals in wastewater treatment plants and rivers in Korea.” Environ. Pollut. 158 (5): 1938–1947. https://doi.org/10.1016/j.envpol.2009.10.036.
Subbiah, M., S. M. Mitchell, J. L. Ullman, and D. R. Call. 2011. “β-Lactams and florfenicol antibiotics remain bioactive in soils while ciprofloxacin, neomycin, and tetracycline are neutralized.” Appl. Environ. Microbiol. 77 (20): 7255–7260. https://doi.org/10.1128/aem.05352-11.
Taneja, N., and M. Sharma. 2019. “Antimicrobial resistance in the environment: The Indian scenario.” Indian J. Med. Res. 149 (2): 119. https://doi.org/10.4103/ijmr.IJMR_331_18.
Thai, P. K., V. N. Binh, P. H. Nhung, P. T. Nhan, N. Q. Hieu, N. T. T. Dang, N. K. B. Tam, and N. T. K. Anh. 2018. “Occurrence of antibiotic residues and antibiotic-resistant bacteria in effluents of pharmaceutical manufacturers and other sources around Hanoi, Vietnam.” Sci. Total Environ. 645: 393–400. https://doi.org/10.1016/j.scitotenv.2018.07.126.
Uddin, M. H., M. S. Islam, and A. M. Ayas. 2018. “A study on efficiency of effluent treatment plants and threat to public health in context of Bangladesh.” Accessed March 13, 2023. http://irjpms.com/wp-content/uploads/2018/05/IRJPMS-PP1812-18.pdf.
USFDA (US Food and Drug Administration). 2013. “Guidance document non-penicillin beta-lactam drugs: A CGMP framework for preventing cross-contamination.” Accessed November 15, 2022. https://www.fda.gov/files/drugs/published/Non-Penicillin-Beta-Lactam-Drugs-A-CGMP-Framework-for-Preventing-Cross-Contamination.pdf.
USFDA (US Food and Drug Administration). 2022. “Non-penicillin beta-lactam drugs: A CGMP framework for preventing cross contamination.” Accessed May 2, 2023. https://www.fda.gov/media/159358/download.
USFDA (US Food and Drug Administration). 2023. Accessed May 2, 2023. https://www.fda.gov/drugs/guidance-compliance-regulatory-information/guidances-drugs.
Watkinson, A. J., E. J. Murby, D. W. Kolpin, and S. D. Costanzo. 2009. “The occurrence of antibiotics in an urban watershed: From wastewater to drinking water.” Sci. Total Environ. 407 (8): 2711–2723. https://doi.org/10.1016/j.scitotenv.2008.11.059.
WHO (World Health Organization). 1997. “A WHO guide to good manufacturing practice (GMP) requirements; Part 1: Standard operating procedures and master formulae.” Accessed March 13, 2023. http://apps.who.int/iris/bitstream/handle/10665/64465/WHO_VSQ_97.02.pdf;jsessionid=372141D23973EEF98B966459699F C563?sequence=1.
WHO (World Health Organization). 2010a. “TRS 957 - Annex 2: WHO good manufacturing practices for active pharmaceutical ingredients (bulk drug substances),” edited by WHO expert committee on specifications for pharmaceutical preparations: Forty-fourth report. Geneva, Switzerland: World Health Organization.
WHO (World Health Organization). 2010b. “WHO good manufacturing practices for pharmaceutical products containing hazardous substances.” Accessed November 15, 2019. https://www.who.int/publications/m/item/trs957-annex3.
WHO (World Health Organization). 2014. “TRS 986 - Annex 2: WHO good manufacturing practices for pharmaceutical products: Main principles.” The document is a revision of WHO Good manufacturing practices for pharmaceutical products: main principles, previously published in WHO Technical Report Series, No. 961, 2011, Annex 3: 77-135. Accessed August 25, 2024. https://www.who.int/publications/m/item/trs986-annex2.
WHO (World Health Organization). 2020. “TRS 1025 - Annex 6: Points to consider for manufacturers and inspectors: environmental aspects of manufacturing for the prevention of antimicrobial resistance.” Accessed November 15, 2022. https://www.who.int/publications/m/item/trs-1025-annex-6.
WHO (World Health Organization). 2022. “Strategic framework for collaboration on antimicrobial resistance: Together for One health.” Food & Agriculture Org. Accessed March 13, 2023. https://apps.who.int/iris/bitstream/handle/10665/352625/9789240045408-eng.pdf?sequence=1&isAllowed=y.
Williamson, D., M. Labbate, R. McMahon, K. Attwell, B. Conlan, C. Degeling, E. Donner, F. El-Assaad, A. Ellis, A. Farrell, and E. Fox. 2017. “An interdisciplinary approach to living in a risky world.” Recommendations from the 2016 Theo Murphy High Flyers Think Tank.: Antimicrobial Resistance: A complex multi-factorial problem requiring an orchestrated interdisciplinary response: 1–21. Accessed March 12, 2023. https://doi.org/10.13140/RG.2.2.34189.03044.
Zaman, M. F., M. S. Akter, and I. B. Muhit. 2015. “Pharmaceutical waste water treatment and the efficiency of ETP in context of Bangladesh.” In Proc., 4th Int. Con., of the Waste Safe, Chittagong, Bangladesh: Chittagong University of Engineering and Technology.
Zhang, X.-X., T. Zhang, and H. H. P. Fang. 2009. “Antibiotic resistance genes in water environment.” Appl. Microbiol. Biotechnol. 82: 397–414. https://doi.org/10.1007/s00253-008-1829-z.

Information & Authors

Information

Published In

Go to Journal of Hazardous, Toxic, and Radioactive Waste
Journal of Hazardous, Toxic, and Radioactive Waste
Volume 29Issue 1January 2025

History

Received: Dec 5, 2023
Accepted: May 14, 2024
Published online: Sep 10, 2024
Published in print: Jan 1, 2025
Discussion open until: Feb 10, 2025

Permissions

Request permissions for this article.

Authors

Affiliations

Ph.D. Student, Dept. of Pharmacy, Jahangirnagar Univ., Savar, Dhaka 1342, Bangladesh (corresponding author). ORCHID: https://orcid.org/0000-0002-9821-7675. Email: [email protected]
Md. Sohel Rana [email protected]
Professor, Dept. of Pharmacy, Jahangirnagar Univ., Savar, Dhaka 1342, Bangladesh. Email: [email protected]

Metrics & Citations

Metrics

Citations

Download citation

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

View Options

Get Access

Access content

Please select your options to get access

Log in/Register Log in via your institution (Shibboleth)
ASCE Members: Please log in to see member pricing

Purchase

Save for later Information on ASCE Library Cards
ASCE Library Cards let you download journal articles, proceedings papers, and available book chapters across the entire ASCE Library platform. ASCE Library Cards remain active for 24 months or until all downloads are used. Note: This content will be debited as one download at time of checkout.

Terms of Use: ASCE Library Cards are for individual, personal use only. Reselling, republishing, or forwarding the materials to libraries or reading rooms is prohibited.
ASCE Library Card (5 downloads)
$105.00
Add to cart
ASCE Library Card (20 downloads)
$280.00
Add to cart
Buy Single Article
$35.00
Add to cart

Get Access

Access content

Please select your options to get access

Log in/Register Log in via your institution (Shibboleth)
ASCE Members: Please log in to see member pricing

Purchase

Save for later Information on ASCE Library Cards
ASCE Library Cards let you download journal articles, proceedings papers, and available book chapters across the entire ASCE Library platform. ASCE Library Cards remain active for 24 months or until all downloads are used. Note: This content will be debited as one download at time of checkout.

Terms of Use: ASCE Library Cards are for individual, personal use only. Reselling, republishing, or forwarding the materials to libraries or reading rooms is prohibited.
ASCE Library Card (5 downloads)
$105.00
Add to cart
ASCE Library Card (20 downloads)
$280.00
Add to cart
Buy Single Article
$35.00
Add to cart

Media

Figures

Other

Tables

Share

Share

Copy the content Link

Share with email

Email a colleague

Share