Abstract
Antimicrobial resistance (AMR) has emerged as a defining microbial threat of the 21st century, compromising the treatment of bacterial, fungal, and viral infections worldwide. The convergence of antimicrobial overuse, globalization, climate change, and healthcare-associated transmission has accelerated the emergence of multidrug-resistant organisms. Advances in genomic epidemiology have clarified the central role of horizontal gene transfer, mobile genetic elements, and environmental reservoirs in resistance dissemination. High-priority pathogens; including carbapenem-resistant Enterobacterales, methicillin-resistant Staphylococcus aureus, multidrug-resistant Mycobacterium tuberculosis, and Candida auris, illustrate the expanding clinical and economic burden of AMR. Meanwhile, antimicrobial development pipelines remain limited, necessitating stewardship, surveillance, and innovative therapeutic approaches. This review synthesizes current epidemiological trends, molecular resistance mechanisms, diagnostic advances, and emerging treatment strategies. We further discuss One Health perspectives and policy initiatives essential for coordinated global mitigation. Addressing AMR requires integrated scientific, clinical, and public health responses to preserve antimicrobial efficacy for future generations.