What are the roles of sex and gender in antimicrobial resistance? Evidence across infection, selection and transmission

Antimicrobial resistance is shaped by biosocial and microbiological processes, yet sex and gender have not been systematically framed across the three domains (infection, antibiotic selection and transmission) that lead to drug-resistant infection. Synthesising available evidence, we find no consistent sex or gender bias in resistance prevalence; where differences are reported, prevalence is more often higher in men. Context-specific analyses are needed to determine how gendered interventions should be, if at all.