As a result of rapid human population growth worldwide, the relationship between global human health and the environment has been explored in greater depth in recent years. Antibiotic abuse with the intent of protecting the health of humans and animals may accelerate the development of antibiotic resistance genes (ARGs) and antibiotic resistant microorganisms (ARMs) which pose health risks to humans, i.e., transfer of vancomycin resistance intestinal enterococci from exposed animals to the human population. A wide variety of ARGs, i.e., sulfonamides, tetracycline, and quinolone resistance genes, have been found in microorganisms throughout water, soil, and air.

There are coselection processes between antibiotic and heavy metal resistance. The underlying coselection mechanisms include (1) different resistance determinants present on the same gene, (2) the same genetic determinant responsible for the resistance to antibiotics and heavy metals, and (3) indirect but shared regulatory responses to antibiotics and heavy metal exposure which is also a potential coselection mechanism. Therefore, heavy metal contamination represents a long-standing selection pressure on the maintenance and spread of ARGs, with both environmental and clinical importance. Heavy metals have also led to their own concerns over their risks on human health and the environment. Although numerous studies have been conducted to address antibiotics, heavy metals and health risks, information remains limited in quite a few aspects of the integrated study of environment and clinical studies with regards to antibiotics and heavy metals. Emerging medicines and technologies that improve human health, especially that can reduce the risk of antibiotic and heavy metal resistance are rare.

This special issue calls for submissions, including original research articles and review articles, that focus on the adverse effects of antibiotics and heavy metals on the environment and human health, as well as the corresponding healthcare and medical treatment strategies. We also welcome the integrated study of environment and clinical studies regarding antibiotics and heavy metals.

Potential topics include but are not limited to the following:

• The interactions and mechanisms between antibiotics, heavy metals and human health
• Influences of drug abuse on the environment and human health, including, but not limited to, antibiotics, and especially emerging contaminants
• Meta-analysis, including, but not limited to, antibiotic/heavy metal resistant microorganism
• Medicines and technologies that improve human health
• Methods and techniques that can reduce the risk of antibiotic and heavy metal resistance