Antimicrobial resistance in agricultural settings: A One Health Approach to understanding cross-sectoral transmission and clinical implications

Background: Antimicrobial resistance (AMR) represents one of the most pressing global health challenges of the 21st century, with agricultural practices playing a pivotal role in its development and dissemination. The extensive use of antimicrobials in livestock production, aquaculture, and crop protection has created selective pressure that drives the evolution and spread of resistant pathogens across the food chain. This review examines the complex interconnections between agricultural antimicrobial use and clinical medicine through a One Health lens, highlighting the mechanisms of resistance development, transmission pathways from farm to fork, and the clinical implications for human health. We discuss the emergence of multidrug-resistant organisms in agricultural settings, their potential for zoonotic transmission, and the impact on treatment efficacy in clinical practice. The review also addresses current surveillance systems, regulatory frameworks, and intervention strategies aimed at mitigating AMR spread from agricultural sources. Understanding these interconnections is crucial for developing comprehensive strategies that balance agricultural productivity with public health protection, emphasizing the need for coordinated action across human, animal, and environmental health sectors.