In this narrative review, the panel of authors examines the broad burdens of AMR for patients and healthcare systems, including excess mortality, underlying disease outcomes, economic costs and the damage to patients’ quality of life. Despite the profound impact on individual wellbeing, the patient voice and patient-reported experience measures are largely absent from current research. To protect the everyday benefits of antibiotics, it is vital to educate all those involved in patient care on how we can combat AMR, including appropriate testing, use of effective antibiotics and infection control procedures. Moreover, given the high investment in novel anticancer treatments, good antimicrobial stewardship has the potential to deliver overall cost savings to healthcare systems while ensuring that patients can safely access and benefit from these therapies. In particular, the board focused on heavily immunocompromised patients, including those with solid cancers, haematological malignancies, and solid-organ transplants, which are particularly vulnerable to AMR. In these patients AMR complicates treatment, prolongs recovery, and heightens the risk of poor outcomes. Beyond the direct health effects, the economic burden of AMR further strains healthcare systems already challenged by the high costs of managing these underlying diseases. Yet, critical gaps persist in research and clinical practice, with inconsistent stewardship, limited access to rapid diagnostics, and a lack of tailored prophylaxis strategies leaving patients at risk and delaying effective intervention. According to authors pannel, addressing these challenges demands stronger recognition of the long-term impact of AMR, coupled with improved stewardship and education for both healthcare providers and patients. At the same time, revitalising the fragile antibiotic development pipeline through sustained investment is essential to ensure earlier access to effective treatments and better outcomes for these highly vulnerable groups.

Antimicrobial resistance (AMR) is an urgent public health threat. Advancements in artificial intelligence (AI) and increases in computational power have resulted in the adoption of AI for biological tasks. <this review explores the application of AI in bacterial infection diagnostics, AMR surveillance, and antibiotic discovery. Authors summarize contemporary AI models applied to each of these domains, important considerations when applying AI across diverse tasks, and current limitations in the field. AI is not a panacea, only a set of (powerful) tools to support humans with domain expertise. Regardless of the sophistication of the model architecture, predictive ability is reliant on the data used to train the model. To adequately model complex chemical-biological systems, training data must be high quality, diverse, and biochemically relevant. While a lack of training data remains, a limiting factor forms any AI applications in biology, there has been a recent increase in public initiatives to support the development of AI tools for biological tasks. These resources aim to collect and organize robust, high-quality data for model training, and provide standardized benchmarks for model evaluation. Specifically for AMR tasks, TDC contains numerous datasets for infectious diseases and standardized benchmarks.

Understanding Shared Multidrug resistance (sMDR) patterns in large antimicrobial surveillance datasets is complex because of the multifaceted nature of the data. Authors explored Pfizer-Atlas (2004 – 2022) and Venatorx-GEARS (2018-2022) datasets from the Vivli platform, focusing on ESKAPEE pathogens. Descriptive data analysis, time-trend analysis, and association rule generation through the a priori algorithm were performed using Python 3.10 libraries pandas, matplotlib, seaborn, scipy. stats, and mlxtend libraries. The best rule set that explored sMDR patterns was visualized in a network format using NetworkX: 3.2 package. “MERIT- Multidrug ESKAPEE Resistance Insights and Tracker” dashboard was created for user-friendly visualization of antimicrobial surveillance datasets, trends in antimicrobial susceptibility profile (ASP) over years, interactive widgets to see the ASP by country and by pathogens, and Network to see significant rules as a result of association rule mining in categories by age, year and country.Time trend analysis revealed a decline in meropenem and piperacillin-tazobactam resistance to E.faecium and doripenem for P. aeruginosa, while resistance to imipenem (K. pneumoniae, A.baumannii, and Enterobacter species) and meropenem (S.aureus, A. baumannii, and Enterobacter species) increased. Association rule mining identified sMDR patterns, such as meropenem and levofloxacin resistance, in S. aureus, K. pneumoniae, P. aeruginosa and A. baumannii. Thus, these findings from the data challenge could aid healthcare professionals in making informed decisions regarding antibiotic use.

This review critically examines the central role of the pharmaceutical industry in addressing antimicrobial resistance, focusing on drug discovery, manufacturing practices, and stewardship efforts. While the industry has made notable contributions through the development of new antimicrobials and alternative approaches such as drug repurposing, artificial intelligence-driven discovery, and improved diagnostics, major challenges persist—including a declining antibiotic pipeline, limited access in low- and middle-income countries, antimicrobial pollution, irrational fixed-dose combinations, and the prevalence of substandard or falsified drugs. To overcome these barriers, this review explores strategic directions, including public-private partnerships, delinked incentive models, small-molecule innovation, ethical marketing, and equitable access strategies. It also underscores the industry’s responsibility in promoting antimicrobial stewardship, participating in global surveillance systems, and educating prescribers and the public on responsible use. Future directions highlight the need for diversified funding, global collaboration, and the adoption of the “triple shield” approach—integrating infection prevention and control, antimicrobial stewardship, and robust surveillance to combat antimicrobial resistance. This review presents an integrated analysis of pharmaceutical accountability, highlighting actionable pathways that align innovation with equitable access, environmental safety, and ethical governance. By bridging gaps between discovery and delivery, the pharmaceutical sector can become a driving force in the global response to antimicrobial resistance.

Relating to the rapid spread of multidrug-resistant gram-negative bacilli (MDR-GNB), of specific importance is the rise of carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant A. baumannii (CRAB), and MDR P. aeruginosa, all of which pose substantial therapeutic challenges with limited treatment options. The COVID-19 pandemic further exacerbated the problem, disrupting antimicrobial stewardship efforts and reversing prior progress made in combating the spread of MDR-GNB in US hospitals and long-term care facilities. In 2019, cefiderocol (Fetroja; Shionogi) (CFDC) received US Food and Drug Administration (FDA) approval as a novel treatment option for MDR-GNB infections. CFDC binds to iron and is actively transported into bacterial cells via iron transport channels, allowing it to bypass traditional resistance pathways such as efflux pumps and porin mutations. Once in the periplasmic space, it inhibits penicillin-binding proteins, disrupting peptidoglycan wall synthesis and ultimately leading to cell death. CFDC is stable against hydrolysis by serine and metallo–β-lactamases, including carbapenemases. This pharmacology makes it a crucial new option for CREs but also for nonfermenting GNB, including CRAB, MDR Pseudomonas, and Stenotrophomonas spp. CFDC initially received FDA approval for the treatment of complicated urinary tract infections (cUTIs) and later expanded to include hospital-acquired pneumonia and ventilator-associated pneumonia. In this context, Clancy and colleagues conducted the PROVE retrospective cohort study to evaluate the real-world safety and effectiveness of CFDC in patients with serious GNB infections. Here, authors summarize the trial data supporting CFDC approval and review how the findings from the PROVE study add and grow those data to clinical practice.