[Development and spread of antibiotic resistance in the environment due to increased anthropogenic input of antibiotic residues and resistant pathogens].

The use of antibiotics for antimicrobial therapy revolutionized medical practice. However, the frequent and sometimes inappropriate use of these drugs in both human and veterinary medicine has had significant consequences. This article provides an overview of the pathways by which antibiotics enter the environment and their impacts.Through wastewater, sewage sludge, and agricultural fertilizers, antibiotics and their degradation products enter various environmental compartments such as soil and water, where they promote the emergence and spread of antimicrobial resistance (AMR) via subinhibitory concentrations of antibiotics. Worldwide, exceedances of ecotoxicological threshold values (predicted no effect concentrations; PNECs) have repeatedly been detected in municipal wastewater treatment plants, surface waters, and agricultural soils.In addition, subinhibitory environmental concentrations act as stress factors that alter the structure and function of microbial communities, thereby disrupting biogeochemical cycles. Bidirectional interactions between climate change and AMR have already been postulated, since altered microbial metabolic processes may trigger climate-relevant feedback mechanisms, while extreme weather events such as floods can further facilitate the dissemination of AMR. The resistance problem therefore requires an integrated, globally coordinated approach in the sense of One Health and Planetary Health.