Question 1

What is antimicrobial resistance?

Accepted Answer

Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi or parasites evolve to resist the effects of medicines that once controlled them. It is driven by overuse and misuse of antibiotics and other antimicrobials in human medicine, veterinary medicine and agriculture — combined with poor infection prevention. The result is infections that are harder to treat, require longer hospital stays, more toxic medicines and carry higher mortality.

Question 2

How many people die from AMR?

Accepted Answer

The GRAM study (Murray et al., Lancet 2022) estimated that AMR was directly responsible for 1.27 million deaths in 2019 and associated with 4.95 million deaths — placing it among the leading global causes of death. The O'Neill Review projected that without action, AMR could kill 10 million people per year by 2050 — exceeding cancer mortality.

Question 3

What drives antibiotic resistance?

Accepted Answer

The main drivers are: overprescription in human medicine (antibiotics prescribed for viral infections, without testing, or at sub-optimal doses); use as growth promoters and prophylaxis in food-producing animals (approximately 70% of medically important antibiotics); poor infection prevention in healthcare and communities; inadequate sanitation releasing resistance genes into the environment; and lack of diagnostics leading to empirical broad-spectrum prescribing.

Question 4

What is antibiotic stewardship?

Accepted Answer

Antibiotic stewardship refers to coordinated interventions to ensure antibiotics are used appropriately — the right drug, at the right dose, for the right duration, for the right indication. Hospital stewardship programmes (using review teams, prescribing guidelines and restriction policies) consistently reduce antibiotic use by 20-30% without worsening outcomes. In primary care, diagnostic tests (rapid point-of-care tests) and delayed prescribing reduce unnecessary use.

Question 5

What is the pipeline crisis for new antibiotics?

Accepted Answer

The antibiotic pipeline is critically inadequate: only approximately 5 new antibiotic classes were approved between 2000 and 2023, compared with dozens in earlier decades. Commercial incentives are misaligned — antibiotics are used briefly and should be used sparingly, making them poor investments for pharmaceutical companies. Several large pharmaceutical companies have exited antibiotic research. New push and pull incentives (subscription models, government commitments to purchase) are being tested to stimulate development.

Question 6

How does agriculture contribute to AMR?

Accepted Answer

Approximately 70% of all medically important antibiotics are used in food-producing animals — often for growth promotion rather than treatment of diagnosed infections. This creates an enormous reservoir of resistant bacteria and resistance genes in animal populations, which can transfer to human pathogens through direct contact, food, water and the environment. WHO, FAO and WOAH jointly advocate for restricting agricultural antibiotic use to veterinary treatment of diagnosed infections only.

Question 7

What are the ESKAPE pathogens?

Accepted Answer

ESKAPE — Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species — are the six bacterial pathogens responsible for the majority of drug-resistant healthcare-associated infections globally. They "escape" the effects of available antibiotics through diverse mechanisms. MRSA (methicillin-resistant S. aureus) is the best known; carbapenem-resistant K. pneumoniae and A. baumannii are increasingly untreatable.

Question 8

What is WHO's AWARE classification?

Accepted Answer

WHO's AWaRe classification categorises antibiotics into Access (first-line, recommended for common infections, should be widely available), Watch (important but higher resistance potential, reserved for specific indications) and Reserve (last-resort antibiotics to be used only when all other options fail — e.g. colistin, ceftazidime-avibactam). National and hospital prescribing policies should target the majority of antibiotic use falling in the Access category.

Question 9

How does infection prevention reduce AMR?

Accepted Answer

AMR is partly a failure of infection prevention — resistant organisms spread within healthcare facilities through unwashed hands, contaminated equipment and poor isolation practices. Hand hygiene compliance is typically only 40% in hospitals globally. Water, sanitation and hygiene (WASH) in communities reduces AMR spread by preventing infections in the first place. Vaccination reduces antibiotic use by preventing bacterial infections (pneumococcal, Hib) and viral infections that lead to inappropriate antibiotic prescribing.

Question 10

What is the AMR Action Fund?

Accepted Answer

The AMR Action Fund is a public-private initiative launched in 2020 by biopharmaceutical companies, the EIB and philanthropic foundations to bridge the antibiotic pipeline gap. It invests in small and medium-sized companies developing new antibiotics, with a goal of bringing 2-4 new antibiotics to patients by 2030. It provides approximately $1 billion in capital but is considered insufficient to solve the structural pipeline problem without additional pull incentives.

Question 11

What is the UN Political Declaration on AMR (2024)?

Accepted Answer

The 2024 UN High-Level Meeting on AMR adopted a political declaration committing member states to reduce the number of deaths attributable to AMR by 10% by 2030 — approximately 127,000 fewer AMR deaths annually compared to 2019 estimates. Commitments include national action plans, surveillance, stewardship and innovation. Implementation of these commitments is voluntary and progress monitoring remains a major gap.

Question 12

How does GMJ News cover AMR?

Accepted Answer

GMJ News tracks WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) reports, clinical trial results for new antibiotics, agricultural antibiotic policy and the One Health dimensions of AMR. Georgia has participated in WHO AMR surveillance and the Georgian Medical Journal has published on AMR trends in the South Caucasus. PHIG's infection prevention work in hospital accreditation directly addresses AMR in Georgian healthcare settings.

GMJ News

Antimicrobial Resistance

Key messages

Key statistics

Glossary of key terms

Latest GMJ coverage

Frequently asked questions 12 Q&A — structured for Google featured snippets and AI discovery

Knowledge hub: guidelines, conventions and reports

Organizations working in migration and health

Related health topics

Company