Antibiotics are among medicine’s most dependable tools, but they work less reliably than they used to. A World Health Organization surveillance report found that about one in six laboratory-confirmed bacterial infections worldwide resisted antibiotic treatment in 2023, and that the problem is growing.
What did the WHO actually find?
On 13 October 2025, the WHO released its Global Antibiotic Resistance Surveillance Report 2025. It drew on data reported by more than 100 countries to the organization’s surveillance system, known as GLASS. The report covers 22 antibiotics used against infections of the urinary and digestive tracts, bloodstream infections and gonorrhea.
Its headline finding was that one in six laboratory-confirmed bacterial infections that cause common illnesses resisted antibiotic treatment in 2023. The qualifiers matter. The figure applies to confirmed infections from a defined set of bacteria and drugs, not to every infection or every antibiotic.
The trend is the more worrying part. Between 2018 and 2023, resistance rose in over 40% of the monitored pathogen-antibiotic combinations, at an average of 5% to 15% a year, according to the WHO.
How does resistance develop in the first place?
Bacteria are not harmed by antibiotics in the way a person might be by a poison. They are living organisms that evolve. When an antibiotic kills most of a bacterial population, any survivors with a genetic edge multiply, and the next infection is harder to treat. Resistance, in other words, is the predictable result of exposure.
The WHO lists several drivers:
- Misuse and overuse of antimicrobials, such as taking antibiotics when they are not needed or taking the wrong type
- Poor access to clean water, sanitation and hygiene
- Inadequate infection prevention and control in homes, health facilities and farms
- Limited access to vaccines, diagnostics and medicines
- Weak awareness and enforcement of relevant legislation
- Too few new antibiotics in development
The NHS puts the personal side plainly: taking antibiotics when they are not needed can make them ineffective for you in the future.
Which bacteria and drugs are most affected?
The 2025 report tracked eight pathogens: Acinetobacter species, Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, non-typhoidal Salmonella, Shigella, Staphylococcus aureus and Streptococcus pneumoniae.
The sharpest numbers involve two gut-dwelling bacteria that are leading causes of bloodstream infections:
| Bacterium | Share resistant to third-generation cephalosporins (global) |
|---|---|
| E. coli | Over 40% |
| K. pneumoniae | Over 55% |
Third-generation cephalosporins are the first-choice treatment for these infections. The WHO also reported that carbapenems and fluoroquinolones, which are often used when first-line drugs fail, are losing effectiveness against E. coli, K. pneumoniae, Salmonella and Acinetobacter. In the WHO African Region, resistance to third-generation cephalosporins in E. coli and K. pneumoniae exceeds 70%.
The WHO’s separate fact sheet adds that ciprofloxacin resistance in gonorrhea stands at 75%.
Where is the burden heaviest?
Resistance is not spread evenly. The WHO reports that in the South-East Asia and Eastern Mediterranean regions, one in three reported infections was resistant. In the African Region the figure was one in five. The global average of one in six sits below both.
A simple worked example shows what those fractions mean. Take 1,000 laboratory-confirmed infections in each setting:
| Setting | Approximate resistant infections out of 1,000 |
|---|---|
| Global average (1 in 6) | About 167 |
| African Region (1 in 5) | 200 |
| South-East Asia and Eastern Mediterranean (1 in 3) | About 333 |
In other words, a patient in the most affected regions faces roughly twice the odds of a resistant infection compared with the global average. These are illustrative calculations from the WHO’s rounded fractions, not exact counts.
The consequences are large. The WHO says bacterial antimicrobial resistance was associated with more than 4.7 million deaths worldwide in 2021. It also projects that treating resistant bacterial infections will cost US$412 billion a year up to 2035, with a further US$443 billion a year in lost productivity.
Why is the picture still incomplete?
Surveillance itself is a weak point. GLASS participation grew from 25 countries in 2016 to 104 in 2023, a more than four-fold increase. Even so, 48% of countries did not report data in 2023, and about half of reporting countries lacked systems to generate reliable data. The true global picture, then, rests on partial information, and the WHO has called on all countries to report high-quality resistance and antibiotic-use data by 2030.
This is also why the “one in six” figure should be read as an estimate drawn from reporting countries rather than a census.
Do antibiotics work for colds, flu and sore throats?
No. Antibiotics treat bacterial infections. The CDC says they do not work on viruses, including those that cause colds, runny noses, flu, most sore throats (strep throat is the exception) and most cases of bronchitis. The NHS likewise says antibiotics do not treat colds, flu or most coughs, and are no longer routinely used for chest infections, ear infections in children or sore throats.
The CDC also notes that some bacterial infections, such as many sinus infections and some ear infections, can get better without antibiotics. Deciding which situation applies is a clinician’s job, which is one reason remote consultations can be a reasonable first step for many ordinary complaints, as covered in our look at telehealth.
Unnecessary antibiotics are not harmless even when resistance is set aside. The CDC lists common side effects including rash, dizziness, nausea, diarrhea and yeast infections, and serious ones such as C. diff infection and severe allergic reactions. For children, it says antibiotic side effects are the most common cause of medication-related emergency department visits.
What can individuals do to slow resistance?
Individual choices will not solve a global problem, but the CDC and NHS guidance is consistent:
- Take antibiotics only when a healthcare professional decides you need them, and take them exactly as prescribed.
- Do not share antibiotics, save leftovers for later or take someone else’s.
- Do not pressure a clinician to prescribe an antibiotic.
- Dispose of unused medicine through a take-back program rather than keeping it.
- Wash hands with soap and water for at least 20 seconds, or use a sanitizer with at least 60% alcohol.
- Stay up to date with recommended vaccines, such as the flu vaccine.
The NHS adds guidance on missed doses: take the missed dose as soon as you remember and carry on as normal, unless the next dose is nearly due, in which case skip it. Never take a double dose. One accidental extra dose is unlikely to cause serious harm but raises the risk of stomach pain, diarrhea, nausea or vomiting, and anyone who takes more than that, or has severe side effects, should contact a clinician or NHS 111.
Clean water and sanitation matter too. The WHO names poor access to them as a driver of resistance, which links this issue to the broader pressures described in our explainer on global water scarcity. Health systems under demographic strain, a theme explored in our piece on the world’s aging population, have all the more reason to keep existing antibiotics working.
What is being done at the global level?
The WHO says its Global Action Plan on antimicrobial resistance for 2026 to 2036 takes a “One Health” approach spanning humans, animals and plants. Its six objectives cover awareness, surveillance and laboratories, infection prevention, equitable access and appropriate use, research and innovation, and governance and financing. It targets a 10% reduction in bacterial resistance-associated human deaths by 2030.
On antibiotic use, the WHO notes that only about 53% of human antibiotic use in 2022 came from “access” antibiotics, which are the narrower, first-line group, against a target of at least 70% by 2030. Closing that gap means prescribing the right drug, not simply fewer drugs.
In a statement accompanying the 2025 report, WHO Director-General Dr. Tedros Adhanom Ghebreyesus said: “Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide.”
A slow-moving problem with practical limits
Resistance does not produce dramatic headlines day to day, but the WHO’s data show it advancing steadily across many drug-and-bacteria pairings, and unevenly across regions. For patients, the useful response is modest: use antibiotics only when they are prescribed, finish them as directed, keep hands clean and keep vaccinations current. Vaccination and hand hygiene, both endorsed by the CDC, reduce the number of infections that need treating at all. For general wellbeing habits, see our guide to better sleep.
This article is general information and not medical advice. Speak to a doctor, pharmacist or other qualified clinician about your own situation.
Sources: World Health Organization; Centers for Disease Control and Prevention; National Health Service
