The Global Epidemiology of Antimicrobial Resistance: Trends, Determinants, and Public Health Implications

Antimicrobial resistance (AMR) is a major global health and development threat that undermines effective treatment of infectious diseases and jeopardizes advances in modern medicine. This review integrates evidence from 2015–2025 using a One Health perspective, linking human, animal, and environmental drivers of resistance. AMR is driven by inappropriate antimicrobial use, inadequate infection prevention, environmental contamination, and weak governance, with the greatest impact in low- and middle-income countries. Despite international action plans and stewardship efforts, progress is limited by inequities in resources, diagnostics, and implementation. The review concludes that reversing AMR trends requires stronger surveillance, responsible antimicrobial use, investment in research and vaccines, and sustained, coordinated global action grounded in One Health principles.