Environmental Antimicrobial Resistance: Key Drivers, Hotspots, Innovative Strategies, and Challenges in the Fight Against Superbugs.

Currently, one of the major global public health concerns that impacts humans, animals, and the environment is antimicrobial resistance (AMR). It poses serious problems for contemporary medicine by casting doubt on the effectiveness of antibiotics and other antimicrobials. The main causes of environmental AMR include the abuse of antibiotics and nonantibiotic substances, such as biocides and heavy metals, in veterinary care, agriculture, and healthcare, which hasten the generation of resistant superbugs. The dissemination of drug-resistant microbes and genetic elements is aided by environmental hotspots, such as hospitals, wastewater treatment facilities, livestock farms, and pharmaceutical production facilities. The Global Action Plan, National Action Plan, antimicrobial stewardship initiatives, improved surveillance, precise diagnostics, infection prevention and control, and the concept of One Health are all components of the multidimensional strategy needed to combat AMR. Promising alternative therapies to conventional treatments include antimicrobial peptides, bacteriophage therapy, immunotherapies, nanotechnology, probiotics, clustered regularly interspaced short palindromic repeats-Cas system, and artificial intelligence. The concept of One Health, recognizing the interdependence of human, animal, and ecosystem health, offers a holistic strategy for addressing AMR. However, implementing these strategies presents significant challenges, including resource limitations and regulatory barriers. This review tries to give a complete picture of AMR by focusing on the main factors that cause it and the hotspots that promote the acquisition of resistance genes. Additionally, it examines approaches to counteract AMR and the obstacles encountered in their execution.