Widespread resistance to common antibiotics is increasing: WHO

Data reported to the World Health Organization’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) from over 100 countries cautions that increasing resistance to essential antibiotics poses a growing threat to global health, with one in six laboratory-confirmed bacterial infections in 2023 found to be resistant to antibiotic treatments.

The WHO’s Global antibiotic resistance surveillance report 2025 presents resistance prevalence estimates across 22 antibiotics used to treat infections of the urinary and gastrointestinal tracts, the bloodstream, and gonorrhoea. The report covers eight common bacterial pathogens — Acinetobacter spp., Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, non-typhoidal Salmonella spp., Shigella spp., Staphylococcus aureus and Streptococcus pneumoniae — each linked to one or more of these infections.

The report found that, between 2018 and 2023, antibiotic resistance rose in over 40% of the pathogen-antibiotic combinations monitored, with an average annual increase of 5–15%. Antibiotic resistance appears highest in the South-East Asian and Eastern Mediterranean regions, where one in three reported infections was resistant; in the African region, one in five infections was resistant. Resistance is also more common and worsening in places where health systems lack capacity to diagnose or treat bacterial pathogens, according to the report.

The report also notes that drug-resistant Gram-negative bacteria are becoming more dangerous worldwide, with the greatest burden falling on countries least equipped to respond. Among these, E. coli and K. pneumoniae are the leading drug-resistant Gram-negative bacteria found in bloodstream infections. These are among the most severe bacterial infections that often result in sepsis, organ failure and death — yet more than 40% of E. coli and over 55% of K. pneumoniae globally are now resistant to third-generation cephalosporins, the first-choice treatment for these infections. In the African region, resistance even exceeds 70%.

Other essential life-saving antibiotics, including carbapenems and fluoroquinolones, are losing effectiveness against E. coli, K. pneumoniae, Salmonella and Acinetobacter. Carbapenem resistance, once rare, is becoming more frequent, narrowing treatment options and forcing reliance on last-resort antibiotics. Such antibiotics are costly, difficult to access, and often unavailable in low- and middle-income countries.

While country participation in GLASS has increased more than fourfold since 2016, 48% of countries did not report data to GLASS in 2023 and about half of the reporting countries still lacked the systems to generate reliable data; indeed, countries facing the largest challenges lacked the surveillance capacity to assess their antimicrobial resistance (AMR) situation. WHO is now calling on all countries to report high-quality data on AMR and antimicrobial use to GLASS by 2030, which will require concerted action to strengthen the quality, geographic coverage and sharing of AMR surveillance data to track progress. Countries should also scale up coordinated interventions designed to address AMR across all levels of health care and ensure that treatment guidelines and essential medicines lists align with local resistance patterns.

“Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “As countries strengthen their AMR surveillance systems, we must use antibiotics responsibly, and make sure everyone has access to the right medicines, quality-assured diagnostics, and vaccines. Our future also depends on strengthening systems to prevent, diagnose and treat infections, and on innovating with next-generation antibiotics and rapid point-of-care molecular tests.”

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