A Comprehensive Review of Antimicrobial Resistance: Mechanisms, Drivers, and Global Strategies

Antimicrobial resistance (AMR) has emerged as a major and rapidly escalating global public health challenge in the twenty-first century. It occurs when microorganisms—including bacteria, viruses, fungi, and parasites—develop the ability to survive exposure to antimicrobial agents that were previously effective, leading to reduced treatment efficacy and increased disease burden. In 2019, AMR was directly responsible for approximately 1.27 million deaths worldwide, and projections suggest this number could rise to 10 million annually by 2050 if effective interventions are not implemented. The rise of AMR is largely driven by the overuse and misuse of antibiotics in clinical practice, agriculture, and livestock production, along with gaps in public awareness, limited surveillance systems, and a declining pipeline of new antimicrobial agents. This review synthesizes findings from selected scientific literature to provide an integrated understanding of antimicrobial resistance. It focuses on the biological mechanisms of resistance, patterns of transmission, epidemiological trends, diagnostic approaches, and global response strategies. Particular emphasis is placed on the One Health framework and international initiatives such as the Global Action Plan on AMR and the Global Antimicrobial Resistance and Use Surveillance System (GLASS). Overall, this review highlights the need for coordinated, multidisciplinary efforts to address AMR and underscores the importance of sustained global action to preserve the effectiveness of existing antimicrobial therapies.