Antibiotic Resistance: Current Status, Molecular Basis, Identification, and Mitigation Approaches

Introduction: Antibiotic resistance or antimicrobial resistance (AMR) is recognized as a global threat and is gradually becoming a key health problem of the 21st century. This review study aims to represent fresh perspectives on the current status of AMR, contributory factors, and management approaches. Methods: The authors accessed the published articles from various platforms, including Google Scholar, PubMed, Scopus, and the National Library of Medicine, using suitable keywords. Including this, webpages of many agencies, like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), were also accessed. Results: AMR caused about 1.27 million deaths in 2019. General contributory factors include self-medication, overuse, and inappropriate prescriptions of antimicrobials. Microorganisms develop antibiotic resistance through various mechanisms, such as antibiotic degradation, modifying target sites, reducing antibiotic molecule permeability, and excluding antibiotics. Antibiotic resistance genes also play a significant role. Discussion: Different factors contribute to the development and spread of AMR. Researchers are using various techniques to identify AMR, such as phenotypic methods, molecular methods, DNA microarrays, and gene sequencing. Moreover, different approaches are being employed to combat AMR, such as the discovery of new antimicrobials, initiatives by global agencies (WHO, CDC), including the AWaRe classification of antibiotics, the One Health Approach, and the Quadripartite Agreement. Conclusions: AMR imposes a significant economic burden on healthcare systems. Strategies such as antibiotic stewardship, understanding AMR at the molecular level, and molecular diagnostics can be crucial in its management. Additionally, coordinated efforts are required from researchers, healthcare providers, policymakers, and the public.