Other AAs in higher concentrations in hospital effluent (relative to community wastewater) included SMX, TMP, and MTZ. With SMX ranging from 0.22-.4.23 µg/L and TMP between 0.6-7.6 µg/L, these corresponding high levels are likely as SMX and TMP are often co-prescribed together. These are in range with other reports of hospital effluents; SMX has been reported between 0.15-373 µg/L and TMP at 0.14 and 7.6 µg/L . MTZ ranged from 10.2-17.1 µg/L in hospital effluent. High quantities of MTZ have also been reported in hospital streams in Sweden , Spain and Vietnam . High levels in hospital effluent were also noted with respective metabolites aSMX (0.7-146.6 µg/L) and hMTZ (6.8-37.6 µg/L). Whilst higher concentrations were often observed for hospital wastewater when compared with community wastewater, several AAs had the opposite trend. For example, TET and OTC had lower concentrations reported in hospital effluent when compared to community wastewater, with OTC at 0.05 ± 0.03 and 0.24 ± 0.16 µg/L, respectively; and TET at 0.03 ± 0.01 and 0.13 ± 0.08 µg/L. This could be attributed to the specific AA usage, TET and OTC are not typically associated with hospitals in the UK, being largely used to treat chlamydia and skin conditions, such as acne and rosacea.