Reviewing regional trends in antibiotic resistance: A cross-country literature analysis

Background: Antibiotic resistance is a growing health concern globally marked by significant regional disparities. Patterns of resistance vary across countries, influenced by factors such as antibiotic usage practices, healthcare infrastructure, and public health policies. High-income countries generally exhibit better control of antimicrobial resistance due to stringent antibiotic stewardship programs, regulated prescribing practices, and robust infection control measures. Despite this, challenges persist with the emergence of multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteriaceae. In contrast, many low- and middle-income countries (LMICs) report disproportionately high levels of resistance, driven by the widespread availability of antibiotics without prescription, poor sanitation, limited diagnostic capabilities, and inadequate surveillance systems. These conditions contribute to the rapid emergence and spread of resistant pathogens, complicating the management of common infections and increasing the burden on already strained health systems. Meanwhile, regions that have implemented comprehensive antibiotic stewardship strategies and public awareness initiatives have seen comparatively lower resistance levels. This review synthesizes current literature on global antibiotic resistance trends to compare resistance patterns across economic settings. It aims to identify common drivers of resistance and highlight regional strengths and vulnerabilities. Understanding these variations is critical for designing context-specific strategies to reduce resistance, support health infrastructure, and promote responsible antibiotic use. A targeted, evidence-based approach is essential to inform global and national policies, bridge regional gaps, and safeguard the effectiveness of existing antibiotics.