Environmental Antimicrobial Resistance: Current Status and Future Prospects

Antibiotics underpin modern medicine and food production, but their indiscriminate use has accelerated antimicrobial resistance (AMR). Here we profile ARG dissemination in water, soil, air and anthropogenic niches such as wastewater treatment plants, intensive farms and landfills. We show that sulfonamide resistance genes (sul1/sul2) dominate aquatic systems, while tetracycline and macrolide genes prevail in livestock environments. Emerging evidence links airborne ARGs to seasonal PM2.5 peaks and long range dust transport. We evaluate state of the art detection platforms—high throughput qPCR, Hi-C metagenomics, nanopore long reads and CRISPR-Cas diagnostics—and discuss their complementarity. Finally, we outline integrated One Health policies that couple real time genomic surveillance with antibiotic stewardship incentives, and spotlight novel agents such as gepotidacin and sulopenem that help address the innovation gap. Coordinated adoption of these strategies is essential to avert a post-antibiotic era. Global cooperation and forward-looking One Health frameworks will be crucial to meeting this challenge.