This year’s theme, “Act Now: Protect Our Present, Secure Our Future,” underscores the urgency of tackling drug resistance before it becomes an irreversible global catastrophe. Antimicrobial resistance (AMR) is accelerating at an alarming rate, threatening to reverse decades of medical progress and placing human, animal, plant, and environmental health at unprecedented risk. As World AMR Awareness Week (WAAW) approaches, from 18 to 24 November 2025, the World Health Organization (WHO) and global partners are calling on all countries to transform political commitments into concrete, life-saving action. This year’s theme, “Act Now: Protect Our Present, Secure Our Future,” underscores the urgency of tackling drug resistance before it becomes an irreversible global catastrophe. The theme reflects renewed momentum following the 2024 United Nations High-Level Meeting on AMR, during which world leaders adopted a political declaration acknowledging AMR as one of the most critical health challenges of the century.

The World Health Organization (WHO) and the European Commission have expanded their strategic partnership to combat antimicrobial resistance (AMR) through a new €3.5 million agreement under the EU4Health programme, strengthening global efforts to address one of the most urgent public-health threats. The funding will support WHO in accelerating research and development of new antibiotics, antifungals and non-traditional therapies, while also improving sustainable and equitable access to both existing and novel antimicrobials worldwide through initiatives such as SECURE, co-led with GARDP. Building on their collaboration launched in 2022, the partnership aligns health security, innovation and access, reinforcing the shared commitment of the EU and WHO to slow the spread of AMR and safeguard the effectiveness of life-saving treatments.

On 10 September 2025, the World Health Organization (WHO) Regional Office for the Eastern Mediterranean brought together an influential panel of more than 40 experts, health professionals ministry of health officials from Gaza and West Bank, and humanitarian organizations for a critical discussion on antimicrobial resistance (AMR) in the Gaza Strip. Gaza faces a convergence of crises that fuel AMR. This includes overcrowding and disrupted health services, limited access to diagnostics and antibiotics, high infection rates and a fragile health system. This panel discussion highlighted the urgent need to address AMR amidst these complex challenges. A recent comment in The Lancet revealed that nearly two thirds of bacterial isolates from Al-Ahli Arab Baptist Hospital (1 November 2023–31 August 2024) were resistant to multiple antibiotics. War injury and trauma-related wounds showed particularly high rates of resistance, underscoring the gravity of the challenges – poor hygiene and infection prevention and the non-availability of proper antibiotics. Panellists and experts stressed that the collapse of routine laboratory surveillance and diagnostic testing hampers antimicrobial stewardship efforts. Panellists emphasized the urgent need for coordinated action to:

• Lift restrictions on medical supplies to Gaza.
• Restore laboratory infrastructure and standardize microbiology practices.
• Update clinical guidelines to address complex conflict-related injuries.
• Strengthen infection prevention and control measures.

Gaza’s health-care system has faced widespread destruction during the ongoing Israeli military invasion that began in October, 2023, leading to a proliferation of disease outbreaks and during this time, one of Gaza’s only functioning microbiology services has been a small laboratory at Al-Ahli Arab Hospital in Gaza City, which retained power largely via diesel generators and battery inverters. The hospital, which is one of the only hospitals in Gaza that has remained partly operational, has treated large volumes of traumatic injuries despite frequent airstrikes (beginning as early as October, 2023, and continuing at the time of writing) in the northern two governorates of the Gaza Strip, and has been evacuated for periods between airstrikes. Authors reviewed every 1317 primary samples—67·3% (886/1317) collected and processed from the hospital’s wards or emergency theatre between Nov 1, 2023, and Aug 31, 2024. Growth was observed in 982 (74·6%) of 1317 specimens; 746 of these (76%) were from wound material, reflecting the overwhelming burden of ballistic and crush trauma. P. aeruginosa predominated (28·4% of isolates [279/982] and 35·9% of wound isolates [268/746]), followed by S.aureus (22·4% of isolates [220/982] and 25·6% of wound isolates [191/746]), Klebsiella spp (18·5% [182/982]), and E.coli (17% [167/982]). Two-thirds of all isolates (66·9% [657/982]) were multidrug resistant, and 86·3% (847/982) had an MAR index greater than 0·20 (mean 0·60), indicating sustained selection pressure. Authors found high resistance among Enterobacterales spp isolates, with more than 90% (384/413) of wound isolates resistant to amoxicillin–clavulanate, cefuroxime, and cefotaxime. Resistance to ceftriaxone and ceftazidime was also alarmingly high in wound isolates (83·4% [246/295] and 79·7% [244/306], respectively), which is suggestive of a widespread presence of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales. Meropenem non-susceptibility reached 63·8% (67/105) in Klebsiella spp, and Pseudomonas showed 33·1% (217/656) multidrug resistance, 16·1% (15/93) colistin resistance, and the highest mean MAR index (0·68; table). Among Gram-positive bacteria, meticillin-resistant S aureus (MRSA) was found in 65·6% of samples (80/122; inferred by cefoxitin), and vancomycin non-susceptibility reached 53·7% (44/82) among S aureus. Proteus and coagulase-negative staphylococci had similarly high MAR values (0·67 for Proteus and 0·48 for coagulase-negative staphylococci).

Antimicrobial resistance affects the delivery of safe and effective healthcare. Antimicrobial resistance has attracted strong political focus, with the 2024 United Nations General Assembly high level meeting providing a clear commitment to reducing mortality and improving antibiotic use. This review summarises recent political action, policy prioritisation, and identification of future threats. It considers infections that are caused by drug resistant pathogens and reviews available and new antibiotics that may meet unmet medical needs. Despite increasing political engagement, the global antimicrobial resistance landscape remains imbalanced. In high income hospital settings, diagnostics, antimicrobial stewardship, and infection prevention and control are improving and may be further enabled by artificial intelligence and information systems. The development and use of new antibiotics is a major focus. By contrast, in low- and middle-income countries, access to most of these advances is limited. In all settings, empirical prescribing of essential antibiotics remains the cornerstone of treatment and conserving their efficacy is critical to effective healthcare. Targeted prevention and optimal treatment strategies are needed to mitigate antimicrobial resistance across all settings.

Approximately, 49 million cases of sepsis (syndrome of life-threatening organ dysfunction that results from dysregulated host response to infection), are recorded worldwide annually, with 11 million sepsis-related deaths, the majority occurring in patients with septic shock. A substantial proportion of survivors suffer from moderate to severe functional limitations including physical, cognitive and psychological disability, exacerbation of pre-existing chronic conditions and a high incidence of re-hospitalisation in the first 12 months after the initial diagnosis. Optimal management of patients with septic shock requires prompt and reliable recognition of patients with sepsis who require additional haemodynamic support. Initially, patients will need judicious iv fluids and consideration of the need for vasopressors such as norepinephrine. Administration of appropriate antibiotics and consideration for control of the source of infection are also required. In the optimisation phase, depending on patients’ comorbidities and response to therapy, the balance of fluid therapy, vasopressors and potentially the addition of an inotropic agent will need to be adjusted, based on clinical findings and haemodynamic and biochemical parameters. For those patients who do not respond to initial therapy, more intensive monitoring may be required with consideration of adjunctive therapies such as corticosteroids, vasopressin, angiotensin II or other rescue therapies to achieve cardiovascular stability. Once stability has been achieved, clinicians need to consider strategies to ameliorate the potential long-term effects on survivors, while keeping in mind the perspective and experience of their patients.

Authors surveyed infectious disease clinicians through the Infectious Diseases Society of America (IDSA) Emerging Infections Network (EIN) about their experience treating CRE infections, availability of resistance mechanism testing, antibiotic choices in four CRE infection scenarios and barriers to using newer antibiotics. They used the 2023 IDSA Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections to classify antibiotic selections for the scenario-based questions as preferred approach, alternative option or not in guidance. For the clinical scenarios, 851 (63%) of 1356 selections were IDSA-preferred approaches; of these, 653 (77%) were for ceftazidime-avibactam, either alone (n = 456) or in combination with aztreonam (n = 197), more than for other β-lactam/β-lactamase inhibitor combination agents active against CRE. For an uncomplicated urinary tract infection caused by carbapenem-resistant K. pneumoniae, where no preferred approaches were available, the most common antibiotic selected was oral fosfomycin (169/343 (49%)). Most clinicians selected antibiotics aligned with the IDSA guidance for serious CRE infections, although the frequent selection of an agent not in the guidance for uncomplicated cystitis suggests that treatment selection is complex and may depend on infection severity, among other factors. The preference for ceftazidime-avibactam among similar agents is notable and may reflect its longer market availability