Risk assessment and management of antimicrobial resistance in clinical and aquatic environments related to pandemics: A review

• Reveal AMR risk issues before and during the pandemic through bibliometric analysis • Review pandemic AMR risk assessment and management with spatiotemporal statistics • Call for strengthened cross-sectoral analysis and AMR risk quantification tools • Advocate for disease surveillance and AMR governance towards sustainable collaboration The widespread misuse of antibiotics has accelerated the global spread of antimicrobial resistance (AMR), posing a significant threat to human health and ecological safety. The coronavirus disease 2019 pandemic markedly altered AMR dynamics in both clinical and aquatic environments, further underscoring the need for a systematic understanding of these changes, but current research lacks a systematic overview of their joint roles in driving AMR during the pandemic. Accordingly, this study focuses on both clinical and aquatic environment settings, providing a comprehensive review of how the pandemic has influenced AMR, AMR risk assessment methods, and historical and recent developments in AMR management related to the settings. Beyond synthesizing literature data on the progression of AMR research, pandemic-era AMR dynamics, and related AMR risk management strategies, this review highlights the implications of these insights for AMR risk assessment and management under global health emergencies. Based on the review, we compared the applications and limitations of existing risk assessment methods, and call for strengthened cross-sectoral collaboration in the post-pandemic context to achieve sustainable disease surveillance and AMR management, addressing challenges across both aquatic environments and clinical systems. The insights and outlook from this review may contribute to the development of risk management technologies and environmental policy concerning AMR mitigation, especially in the context of managing emerging contaminants in the post-pandemic era.