Global antibiotic resistance rises across the world, WHO reports
The World Health Organization (WHO) has sounded the alarm on widespread antibiotic resistance, revealing that about one in six laboratory-confirmed bacterial infections in 2023 were resistant to common antibiotics. The new Global Antibiotic Resistance Surveillance Report 2025 shows troubling gains in resistance across a wide set of pathogen–antibiotic combinations and underscores the urgent need to strengthen surveillance, diagnostics, and access to effective treatments worldwide.
Key findings from the 2025 surveillance report
Data gathered through the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) encompassed more than 100 countries. Between 2018 and 2023, resistance rose in over 40% of the monitored pathogen–antibiotic combinations, with an average annual increase ranging from 5% to 15%. The report adds new resistance prevalence estimates across 22 antibiotics used to treat urinary and gastrointestinal infections, bloodstream infections, and gonorrhoea, covering eight common bacterial pathogens: Acinetobacter spp., Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, non-typhoidal Salmonella spp., Shigella spp., Staphylococcus aureus, and Streptococcus pneumoniae.
Where resistance is highest
Regionally, the WHO notes that antibiotic resistance is most pronounced in the South-East Asia and Eastern Mediterranean Regions, where about one in three reported infections were resistant. In the African Region, roughly one in five infections showed resistance. The report emphasizes that resistance is concentrated in areas with weaker health systems, where diagnosing and treating bacterial infections is more challenging.
Danger posed by Gram-negative bacteria
The study highlights that drug-resistant Gram-negative bacteria are the greatest global threat. E. coli and Klebsiella pneumoniae are the leading Gram-negative pathogens found in bloodstream infections, conditions that can escalate to sepsis and organ failure. Alarmingly, more than 40% of E. coli and over 55% of K. pneumoniae infections worldwide are resistant to third-generation cephalosporins—the first-line treatment for many serious infections. In Africa, cephalosporin resistance in these pathogens climbs above 70% in some settings.
Resistance to other critical antibiotics—carbapenems and fluoroquinolones—is rising as well in E. coli, K. pneumoniae, Salmonella, and Acinetobacter. Carbapenem resistance, once rare, is increasingly common, limiting therapeutic options and often leaving clinicians with last-resort antibiotics that are costly, hard to access, and frequently unavailable in low- and middle-income countries.
Progress in AMR surveillance, but more action needed
GLASS participation has surged—from 25 countries in 2016 to 104 in 2023. Yet nearly half of all countries did not report data to GLASS in 2023, and many that did report lacked robust systems to generate reliable data. The report argues that the most vulnerable countries lack the surveillance capacity to assess their AMR situation accurately, hindering targeted responses.
Global action and the path forward
The 2024 UN General Assembly political declaration on AMR called for strengthened health systems and a One Health approach that unites human health, animal health, and environmental sectors. To curb AMR, WHO urges countries to strengthen laboratory systems, ensure reliable surveillance data—especially from underserved areas—and align treatment guidelines with local resistance patterns. The agency aims for all countries to report high-quality AMR and antimicrobial-use data to GLASS by 2030, a goal that will require sustained investment and coordinated interventions across healthcare levels.
What this means for patients and healthcare systems
For patients, rising resistance translates into longer illnesses, higher risk of severe outcomes, and greater dependence on more costly or less accessible therapies. For healthcare systems, the message is clear: without robust surveillance, rapid diagnostics, and stewardship to preserve antibiotic effectiveness, medical advances in surgery, oncology, neonatology, and critical care could be compromised. The WHO’s call to action emphasizes responsible antibiotic use, improved diagnostics, vaccination, and infection prevention as immediate, practical steps alongside long-term investments in new antibiotics and rapid testing technologies.
In short, while the GLASS report shows progress in tracing AMR trends, it also highlights a widening gap between surveillance capacity and the real-world burden of resistant infections. The next several years will be critical in implementing the One Health approach and ensuring access to effective treatments, where appropriate, across all regions of the world.
