The Growing Threat of Antibiotic Resistance: A Comprehensive Review

Abstract: Antibiotic resistance (AR) is one of the most acute problems of contemporary healthcare, as it risks destroying decades of achievements in infectious disease treatment. It happens when bacteria develop their system to resist drugs, which are used to inhibit or kill them, making common infections more difficult or even impossible to cure. The global impact is ultimately huge: in 2019 alone, over 1.27 million deaths and almost 5 million worldwide were directly linked to antimicrobial resistance (AMR). The low and middle-income countries have the worst burden because of insufficient surveillance, unregulated access to antibiotics, and a lack of proper healthcare infrastructure. The causes of resistance are complex. On a microbial level, e.g., through enzymatic drug inactivation (e.g., β-lactamases), decreased membrane permeability by altered porins, active efflux pumps, and target modification. At a societal level, antibiotic abuse and overuse by humans, veterinarians, and farmers will speed up the development and dissemination of resistant strains. The crisis is only worsened by globalization, inadequate infection prevention, and the absence of prompt diagnostics. Possible new approaches to resistance are new antimicrobials, combining existing drugs, using bacteriophages and probiotics, and real-time resistance surveillance using next-generation sequencing. As important are non-drug approaches to intervention, including antimicrobial stewardship programs, vaccination, enhanced infection control, and global One Health programs that connect human, animal, and environmental health. Finally, antibiotic resistance is not a hypothetical disaster but a current worldwide health crisis that has significant clinical, social, and economic impact. It will need combined efforts on the international level, continued spending on innovation, and immediate efforts in all spheres to maintain the efficacy of the currently existing drugs and ensure the future of combating infectious diseases.