Global alarm over antibiotic resistance
The World Health Organization (WHO) has issued a stark warning: antibiotic resistance is spreading worldwide, with one in six laboratory-confirmed bacterial infections in 2023 showing resistance to standard treatments. The Global Antimicrobial Resistance and Use Surveillance System (GLASS) data from more than 100 countries indicate that resistance grew in over 40% of monitored pathogen–antibiotic combinations between 2018 and 2023, at an average annual rise of 5–15%.
This detection of broad resistance underscores a long-standing challenge: our medical advances in treating infections could be eroded if resistant bacteria become the norm rather than the exception. The new Global Antibiotic Resistance Surveillance Report 2025 provides, for the first time, resistance prevalence estimates across 22 antibiotics used to treat urinary, gastrointestinal, and bloodstream infections, as well as gonorrhoea. Eight common bacterial pathogens are tracked, including Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, Staphylococcus aureus, and Streptococcus pneumoniae, each linked to one or more of these infections.
Where resistance is most pronounced
Regional patterns reveal that antibiotic resistance is not uniform. WHO estimates that the burden is highest in the South-East Asia and Eastern Mediterranean Regions, where roughly one in three reported infections showed resistance. In the African Region, about one in five infections were resistant. Regions with weaker health systems, limited diagnostic capacity, and insufficient access to effective antibiotics face the greatest risks.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said: “Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide. As countries strengthen their AMR surveillance systems, we must use antibiotics responsibly, ensure access to quality diagnostics, vaccines, and medicines, and invest in prevention, rapid testing, and new antibiotics.”
The toughest challenges are Gram-negative bacteria
The report highlights that drug-resistant Gram-negative bacteria are the most dangerous global threat. E. coli and K. pneumoniae are leading resistant culprits in bloodstream infections, conditions that can progress to sepsis and organ failure. Alarmingly, more than 40% of E. coli and over 55% of K. pneumoniae globally are now resistant to third-generation cephalosporins—the standard first-line treatment for many serious infections. In Africa, resistance to these drugs exceeds 70% in some settings.
Beyond cephalosporins, resistance to other essential medicines, including carbapenems and fluoroquinolones, is rising among E. coli, K. pneumoniae, Salmonella, and Acinetobacter. Carbapenem resistance, once rare, is becoming more frequent, narrowing therapeutic options and forcing reliance on last-resort antibiotics that are costly, less accessible, and frequently unavailable in low- and middle-income countries.
Progress, but uneven progress in surveillance
GLASS participation has surged—from 25 countries in 2016 to 104 in 2023—yet the picture remains incomplete. In 2023, 48% of countries did not report data to GLASS, and about half of reporting nations still lacked reliable data-generation systems. Countries facing the greatest challenges often lack surveillance capacity to gauge their AMR situation, hampering timely policy responses.
In 2024, a UN General Assembly political declaration set targets to address AMR through stronger health systems and a One Health approach that links human health, animal health, and the environment. The WHO urges all nations to report high-quality AMR and antimicrobial-use data to GLASS by 2030. Achieving this goal will require expanding surveillance coverage, improving data quality, and aligning treatment guidelines with local resistance patterns.
What needs to happen next
Experts agree that several actions are essential: scale up laboratory capacity and reliable data sharing; strengthen health systems to diagnose and treat bacterial infections promptly; ensure access to quality medicines and diagnostics; and promote responsible antibiotic use across human, animal, and environmental health. Countries should implement targeted interventions and align essential medicines lists with current resistance data to preserve antibiotic effectiveness for as long as possible.
While the situation is dire, the report also highlights a path forward: robust AMR surveillance, informed policy decisions, and investment in new diagnostics and antibiotics. The combined effect of these measures could slow resistance growth, improve patient outcomes, and safeguard the gains of modern medicine for future generations.
