Environmental occurrence of antibiotic resistance, control measures and challenges in finding therapeutic management

Antimicrobial resistance represents a growing threat to public health, with the World Health Organization placing it among the top ten global health threats. Inappropriate use of antibiotics in healthcare and agriculture contributes to their dispersal into the environment, thereby accelerating bacterial resistance through the transfer of genetic elements and antibiotic resistance genes. The widespread prevalence of antibiotic-resistance genes and bacteria has been confirmed in both soil and water across various climates. Additionally, the detection of these resistant genes and bacteria in polar regions is particularly alarming due to their potential to spread and persist in pristine environments. The impact of antibiotic resistance is considerable, and addressing the associated challenges necessitates a collaborative effort involving healthcare professionals, government entities, scientists, and the general public. Most of the recent scholarly reviews regarding antibiotic resistance predominantly concentrate on either the overarching concept of antimicrobial resistance or they delve into particular sources, pathways, or environmental ramifications. In contrast, this extensive state-of-the-art review aspires to furnish an updated synthesis of the distribution of antibiotic resistance, its repercussions on human health and economy, as well as innovative therapeutic strategies that exhibit potential in combating antibiotic- resistant bacteria. Furthermore, it scrutinizes the challenges that impede the progression of novel therapeutic modalities and the implementation of effective control strategies. The investigation provides a comprehensive overview of the classifications of antibiotic resistance genes, systematically organized by antibiotic categories. Additionally, it underscores global management strategies, particularly through stewardship programs, promising combination therapies aimed at augmenting drug efficacy, and alternative methodologies to antibiotics for the treatment of bacterial infections. (c) 2024 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).