Global Antibiotic Resistance Surveillance Report 2025

Overview

The World Health Organization (WHO) has released a new report, the Global Antibiotic Resistance Surveillance Report 2025. Report reveals that one in six laboratory-confirmed bacterial infections causing common infections in people worldwide in 2023 were resistant to antibiotic treatments. Between 2018 and 2023, antibiotic resistance rose in over 40% of the pathogen-antibiotic combinations monitored, with an average annual increase of 5–15%.  Data reported to the WHO 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. 

The new report presents, for the first time, resistance prevalence estimates across 22 antibiotics used to treat infections of the urinary and gastrointestinal tracts, the bloodstream and those used to treat gonorrhoea. The report covers 8 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.

Key findings

• Country participation in GLASS has increased four-fold since 2016, but regional gaps persist: Since 2016, 110 countries, including three territories and areas, have submitted AMR data to GLASS. In 2023, 104 countries reported data, an increase of over 300% compared to the 25 countries that reported in 2016, the first year of data collection.
• Global resistance is extensive, with wide regional variations: In 2023, approximately one in six laboratory-confirmed bacterial infections worldwide were caused by bacteria resistant to antibiotics. Median resistance was most common in urinary tract infections (approximately 1 in 3) and bloodstream infections (1 in 6) and less so in gastrointestinal (1 in 15) and urogenital gonorrhoeal infections (1 in 125). Resistance was most frequent in the South-East Asia and Eastern Mediterranean regions (almost 1 in 3 infections), followed by the African Region (1 in 5), all above the global median (Fig. 2). Resistance was less frequent in the European Region (1 in 10) and least frequent in the Western Pacific Region (1 in 11), indicating wide regional disparity.
• Trends in AMR indicate an increasing threat from Gram-negative bacterial pathogens: AMR has increased in 40% of the pathogenantibiotic combinations monitored for global temporal trends between 2018 and 2023, with annual relative increases ranging from 5% to 15%, depending on the combination.
• Settings with lower AMR surveillance coverage report higher levels of AMR: The frequency of AMR is highest in countries with low surveillance coverage. In fact, there is a strong inverse correlation between a country’s AMR surveillance coverage and its reported median AMR.
• Antibiotic resistance disproportionately affects LMICs and fragile health systems, forming a syndemic: Socioeconomic factors and the strength of health systems are key determinants of the AMR burden, with the frequency of AMR increasing when health systems are weaker. In fact, there was a strong inverse correlation between the universal health coverage (UHC) service coverage index.

Priorities for action

• Countries should overcome structural and operational barriers to data collection, improve the coverage and representativeness of their national AMR surveillance system, use the data for decision-making, and ensure timely sharing of national AMR data to GLASS by 2030, in line with the commitments made in the 2024 United Nations General Assembly political declaration on AMR.
• Countries should implement integrated intervention packages that include infection prevention and control, water, sanitation and hygiene, vaccination, antimicrobial stewardship, and strengthening of laboratory services aligned with WHO’s people-centred approach.
• Countries must improve their capacity to conduct AMR surveillance, including enhancing representativeness and strengthening laboratories and data systems.
• Countries should reduce use of AWaRe “Watch” antibiotics and increase use of “Access” antibiotics to at least 70% by 2030, to meet the target set in the 2024 political declaration on AMR. At the same time, they should also organize the next recourse to treatment by extending access – while ensuring prudent use, of “Reserve” antibiotics in settings with documented multidrug resistance.
• Countries should address AMR through broader strategies that strengthen health systems, enhance resilience, and expand social protection, such as UHC and multisectoral initiatives, with equity and access at the core.