Resistance to antibiotics is growing around the world, while we remain short of effective therapies against common infections, such as urinary tract infections.
In 2023, one in six laboratory-confirmed infections was resistant to antibiotics: the WHO report outlines the contours of one of the most pressing global public health problems Global antibiotic resistance surveillance report 2025a paper published on October 13 that collected data on more than 23 million bacterial infections in 104 countries.
According to the analysis, more than 40% of the most common antibiotics were losing effectiveness against widespread urinary tract, blood, intestinal, or sexually transmitted infections between 2018 and 2023.
Not the same everywhere
Worldwide, the spread of bacterial infections that do not respond to antibiotics has been increasing, by up to 15% per year, although not at the same rate everywhere. The highest rates were in Southeast Asia and the eastern Mediterranean region, with one in three bacterial infections resistant to antibiotics – an incidence two times higher than the global average and more than three times higher than data from Europe and the Western Pacific.
In general, antibiotic-resistant infections have a higher prevalence in low- and middle-income countries, those with the most fragile health systems. The phenomenon is on the rise and threatens to overshadow some of the achievements of modern medicine: according to WHO estimates, every year treatment-resistant bacterial and fungal infections kill more than one million people and contribute to the deaths of almost five million others. A study published in the journal Lancet in September 2024 it estimated that over the next 25 years, these infections will be responsible for the deaths of more than 39 million people.
Investing in antibiotics pays little (immediately)
In addition to the improper use of antibiotics on humans, animals and in agriculture and the natural tendency of pathogens to evolve to resist drugs that neutralize them, the scarcity of new classes of antibiotics available also affects the problem. If, in fact, the search for new drugs is essential, that of new generation antibiotics is extremely complex and investments in the sector are very risky – often unsustainable for companies. Yet, in the long run, resistant infections translate into enormous economic losses, due to the lack of productivity and the premature death of many workers who contract them.
Unscratchable armor
Of particular concern are Gram-negative bacteria, that is, those protected by an external membrane that is difficult for antibiotics to penetrate, such asEscherichia coli and it Klebsiella pneumoniae. These bacteria are acquiring increasing resistance to antibiotics and can cause life-threatening conditions such as sepsis, an acute systemic inflammation that requires immediate treatment.
This type of infection is developing resistance to cephalosporins, the antibiotics of choice against Gram-negative bacteria. In the African region, more than 70% of infections are resistant to cephalosporins.
Close to a critical threshold
For Manica Balasegaram, a scientist at the Global Antibiotic Research and Development Partnership among the signatories of the report, it is clear that we are close to a point of no return in the fight against antibiotic-resistant infections. “Until now, the narrative on antimicrobial resistance has rightly focused on the overuse of antibiotics, but this is no longer enough. To avoid the point of no return, we must also focus efforts on accelerating innovation and increasing their appropriate use.”
