Epistemological perspective on antimicrobial resistance in the one health context

Antimicrobial resistance (AMR), once a natural evolutionary phenomenon, has become a critical global public health threat due to the excessive and indiscriminate use of antibiotics. Over recent decades, widespread antibiotic use in clinical, agricultural, and environmental settings has exerted substantial selective pressure on microbial populations, accelerating the emergence and horizontal transfer of resistance genes. These resistant organisms, and their genetic elements, now circulate not only in healthcare systems but also in natural ecosystems, highlighting the scale and complexity of the problem. This study adopts a qualitative, applied research design grounded in a multiple case study methodology with cross-case synthesis, complemented by bibliometric network analysis using VOSviewer software. A literature review spanning the years 2014 to 2024 was conducted using a curated set of interdisciplinary keywords to capture the convergence of environmental science, microbiology, and public health. The findings revealed thematic clusters and knowledge structures associated with AMR, particularly its links to environmental contaminants such as heavy metals. By situating AMR within the One Health framework, this manuscript emphasizes the interconnectedness of human, animal, and environmental health. It calls for integrative and transdisciplinary strategies capable of responding to the biological, social, economic, and policy-related dimensions of AMR, underscoring the urgent need for systemic and coordinated global action.