Cytotoxic comparison of macrolide antibiotics and their chlorinated disinfection byproduct mixtures

Erythromycin (ERY), azithromycin (AZI) and telithromycin (TEL) are widely-used macrolide antibiotics that are frequently detected in various water environments, including resource water and drinking water. In the performed chlorination disinfection process, at least 10, 20 and 200 new disinfection byproducts of ERY, AZI and TEL, respectively, were observed (the mixtures of the disinfection byproducts of ERY, AZI and TEL were named ERY-M, AZI-M and TEL-M, respectively). There is limited information available regarding their comparative toxicities, and their potential health risks are still unknown. In this study, the Jurkat cell line was used to compare the toxicities of the disinfection byproduct mixtures and their precursor compounds. The cell viability results indicated that the toxicity of ERY-M may not be enhanced after disinfection by chlorination. In contrast, at the same concentrations, AZI-M and TEL-M induced more significant inhibitory effects on cell viability than their parent compounds. Additionally, the total antioxidant capacity (T-AOC) and cell cytokine release (including interleukin-2, interleukin-8 and tumor necrosis factor-α) analyses of AZI-M and TEL-M further verified these results. Our findings demonstrate that the cytotoxicity of AZI and TEL was enhanced during the chlorination disinfection process. This investigation will provide substantial new details related to the toxicity of the mixed disinfection byproducts (DBPs) of ERY, AZI and TEL generated in the chlorination disinfection process. [Display omitted] •In the chlorination disinfection process,about 10, 20 and 200 new DBPs of ERY, AZI and TEL, respectively, were generated.•The toxicity of ERY-M may not be enhanced after disinfection by chlorination.•AZI-M and TEL-M exhibit more toxic effects than their parent compounds.•The potential toxicity of AZI-M and TEL-M should be paid more attention.