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Antibiotic resistance

February 25, 2026

Antibiotic resistance is among the greatest challenges facing health systems worldwide. This article explains clearly how resistance develops, why healthcare facilities are particularly affected, and which measures – especially hygiene, disinfection and antibiotic stewardship – have been proven to help prevent transmission.

Table of contents

  1. Antibiotic resistance – a silent global health crisis
  2. How does antibiotic resistance develop?
  3. Why hospitals and care homes are particularly affected
  4. Hygiene as the most effective preventive measure
  5. The role of single-use products in infection prevention
  6. Antibiotic stewardship – responsible antibiotic use
  7. One Health, the environment and a look into the ice cave
  8. Research, innovation and future perspectives
  9. Conclusion: Antibiotic resistance is manageable – but only through consistent action
  10. References

Antibiotic resistance: a silent global health crisis

Antibiotics are among the most significant medical achievements of the 20th century. Since Alexander Fleming’s discovery of penicillin in 1928, bacterial infections that were previously often fatal could be treated. Surgery, cancer therapies, organ transplants and modern intensive care would be barely conceivable without effective antibiotics.

However, this medical progress is increasingly at risk.

A growing threat to global health

Antibiotic resistance occurs when bacteria develop mechanisms to evade the effects of an antibiotic. The medicine loses its effectiveness – the infection becomes harder to treat or even untreatable.

The World Health Organization (WHO) classifies antibiotic resistance (antimicrobial resistance, AMR) as one of the greatest global health threats.¹

A widely cited study in the journal The Lancet estimated that in 2019, around 4.95 million deaths worldwide were associated with bacterial resistance. About 1.27 million deaths could be directly attributed to resistant pathogens.²

By comparison, antibiotic-resistant infections are already on a scale comparable to HIV or malaria.

The economic impact is also substantial. The OECD forecasts that, without countermeasures, resistant infections in Europe, North America and Australia could cause hundreds of thousands of additional deaths and drive billions in healthcare costs.³

Why people speak of a “silent pandemic”

Antibiotic resistance does not spread abruptly like a virus in a pandemic. It develops gradually – often unnoticed – in hospitals, care facilities, outpatient care, livestock farming and even in the environment.

Resistant bacteria such as:

  • MRSA (methicillin-resistant Staphylococcus aureus)
  • ESBL-producing Enterobacterales
  • VRE (vancomycin-resistant enterococci)
  • Carbapenem-resistant pathogens (CRE)

present medical facilities worldwide with enormous challenges.

The problem is compounded by the fact that the development of new antibiotic classes is progressing only slowly. While bacteria adapt evolutionarily, the pipeline of new active substances is stagnating.

Key distinction: antibiotics work only against bacteria

A central point in public discourse is correct classification:

Antibiotics act exclusively against bacteria – not against viruses.

Colds, influenza or COVID-19 are viral infections. The unnecessary use of antibiotics for viral illnesses nevertheless accelerates resistance development, because susceptible bacteria are killed and resistant germs survive.

Why the issue particularly affects facilities

Healthcare facilities are at the heart of the resistance problem:

  • High levels of antibiotic prescribing
  • Immunocompromised patients
  • Invasive interventions (catheters, ventilation, surgery)
  • High pathogen burden and close patient contact

Every day, the decision is made here as to whether resistance is contained or further spread.

This makes it clear: antibiotic resistance is not only a pharmacological or microbiological problem. It is also a matter of structural quality, hygiene, prevention and responsible action.

The next section therefore explains how resistance develops biologically – and why it is evolutionarily inevitable, but massively accelerated by human behaviour.

How does antibiotic resistance develop?

Antibiotic resistance is not a random event, but the result of biological adaptation processes. Bacteria have an exceptional ability to change genetically and adapt to environmental conditions. Under the selective pressure exerted by antibiotics, this process accelerates considerably.

To understand the problem, it is worth looking at the underlying mechanisms.

How do antibiotics work at all?

Antibiotics target vital processes in bacteria. Depending on the drug class, this happens, for example, through:

  • Inhibition of cell wall synthesis (e.g. penicillins, cephalosporins)
  • Disruption of protein synthesis (e.g. macrolides, tetracyclines)
  • Interference with DNA replication (e.g. fluoroquinolones)
  • Inhibition of key metabolic pathways

Importantly, these targets exist only in bacteria – which is why antibiotics do not work against viruses.

When an antibiotic is used, susceptible bacteria die. However, if individual germs with genetic adaptations survive, they can multiply. This is exactly where the resistance problem begins.

Mutation and natural selection

Resistance often arises through random genetic mutations.

For example, if the structure of a bacterial enzyme or receptor changes slightly, the antibiotic can no longer bind effectively. The bacterium survives – while others die.

This process follows a classic evolutionary principle:

  1. Random mutation
  2. Selective pressure from antibiotics
  3. Survival of resistant bacteria
  4. Multiplication and transmission of resistance

The more frequently and improperly antibiotics are used, the greater the selective pressure.

Horizontal gene transfer – bacteria “share” resistance

Particularly problematic is the fact that bacteria not only pass resistance genes to their offspring, but can also exchange them with one another.

This so-called horizontal gene transfer occurs, among other ways, via:

  • Plasmids (small, mobile DNA rings)
  • Transposons (“jumping genes”)
  • Bacteriophages (viruses that infect bacteria)

As a result, resistance can spread within a very short time between different bacterial species. Even harmless gut bacteria can pass resistance genes to pathogenic organisms.

This mechanism explains why resistance spreads globally so quickly.

Multidrug-resistant organisms (MDRO)

Multidrug-resistant organisms are bacteria that are resistant to several antibiotic classes at the same time.

Important examples include:

  • MRSA – resistant to methicillin and other beta-lactam antibiotics
  • ESBL-producing Enterobacterales – produce enzymes that inactivate many penicillins and cephalosporins
  • VRE – resistant to vancomycin
  • Carbapenem-resistant Enterobacterales (CRE) – often affecting last-resort therapeutic options

Such pathogens significantly restrict treatment options and more often lead to complications, longer hospital stays and increased mortality.¹

Natural vs acquired resistance

Not every resistance is newly developed.

  • Natural (intrinsic) resistance: Some bacterial species are naturally insensitive to certain antibiotics.
  • Acquired resistance: Develops through mutation or gene transfer.

Studies have shown that resistance genes already exist in very old environmental samples – even in permafrost that is thousands of years old.²

Resistance is therefore an evolutionary phenomenon. What is new, however, is the speed and scale of its spread – significantly influenced by human behaviour.

Why human activity accelerates development

Several factors increase selective pressure:

  • Excessive or unnecessary antibiotic prescribing
  • Therapy durations that are too short or too long
  • Use of broad-spectrum antibiotics
  • Antibiotic use in livestock farming
  • Inadequate hygiene in facilities
  • Global mobility

In healthcare facilities in particular, high antibiotic use, vulnerable patient groups and close contact come together – ideal conditions for the selection and spread of resistant germs.

This makes it clear: resistance development is biologically understandable – but can be influenced through structural, hygiene and organisational measures.

The next section therefore explains why hospitals and care homes play a key role in resistance dynamics.

Why hospitals and care homes are particularly affected

Healthcare facilities are at the centre of the resistance problem. Here, several risk factors coincide: high antibiotic consumption, vulnerable patient groups, invasive interventions and a high pathogen burden. This combination creates ideal conditions for the emergence and spread of antibiotic-resistant pathogens.

High antibiotic use as selective pressure

Antibiotics are frequently used in hospitals – both therapeutically and prophylactically, for example prior to surgery. Particularly in intensive care units, many patients receive broad-spectrum antibiotics.

Every antibiotic dose creates selective pressure: susceptible bacteria are eliminated, resistant germs survive and can spread. In facilities with high antibiotic density, this effect is significantly amplified.

The Robert Koch Institute (RKI) regularly points out that the rational use of antibiotics is one of the central measures to prevent resistance.¹

Vulnerable patient groups

Hospitals and care homes accommodate a disproportionately high number of people with:

  • weakened immune systems
  • chronic illnesses
  • advanced age
  • open wounds
  • catheters or vascular access
  • mechanical ventilation

Such patients are more susceptible to infections – and therefore also to infections with resistant pathogens.

Particularly problematic: even harmless skin or gut bacteria can cause severe courses of disease in immunocompromised individuals.

Invasive interventions as a portal of entry

Modern medicine relies on numerous invasive procedures:

  • urinary catheters
  • central venous catheters
  • drains
  • surgical procedures
  • ventilation systems

These interventions breach natural barriers such as skin or mucous membranes. This gives bacteria direct access to the bloodstream or internal organs.

Many healthcare-associated infections (hospital-acquired infections) are associated with such interventions.

Healthcare-associated infections – an underestimated risk

Healthcare-associated infections affect millions of patients in Europe each year.²

Resistant pathogens are playing an increasing role. Typical infection types include:

  • post-operative wound infections
  • urinary tract infections
  • ventilator-associated pneumonia
  • sepsis

Resistant infections more often result in:

  • longer hospital stays
  • more intensive treatment
  • higher treatment costs
  • increased mortality

Biofilms and persistent pathogens

Another factor is the formation of biofilms.

Biofilms are bacterial communities that settle on surfaces – for example on catheters, implants or medical devices. In this structure, bacteria are particularly resilient to antibiotics and disinfection measures.

Biofilms can promote chronic infections and represent a particular challenge for hygiene.

Transmission through contact

In facilities, resistant pathogens are often spread via:

  • staff hands
  • medical equipment
  • shared surfaces
  • insufficiently reprocessed materials

This makes it clear: resistance is not only a pharmacological problem, but also a hygiene problem.

Inadequate hand hygiene or poor surface disinfection can contribute to the onward transmission of multidrug-resistant germs – even if antibiotic therapy is carried out correctly.

Care homes as a particular challenge

Care homes are also relevant in resistance dynamics:

  • close physical proximity
  • frequent hospital transfers
  • chronically ill residents
  • repeated antibiotic therapies

Studies show that resistant pathogens can circulate between hospitals and care homes – a so-called “revolving door effect”.

Facilities as a key setting for prevention

The good news: healthcare facilities are not only risk zones, but also central settings for prevention.

Through structured measures, facilities can:

  • interrupt transmission routes
  • slow resistance development
  • increase patient safety

Hygiene, disinfection, protective clothing and standardised processes play a decisive role.

The next section therefore explains why consistent hygiene measures – particularly hand disinfection, surface disinfection and the appropriate use of protective products – are regarded as the most effective strategy against the spread of resistant pathogens.

Hygiene and disinfection: effective prevention against resistant germs

Antibiotic resistance cannot be controlled by new medicines alone. The most effective lever lies in preventing infections and breaking chains of transmission.

The fewer infections occur, the fewer antibiotics are needed – and the lower the selective pressure on bacteria.

Hygiene is therefore not an ancillary measure, but a core component of any resistance strategy.

Hand hygiene – the single most important measure

Hands are the most common route of transmission for pathogens in healthcare settings.

The WHO defines clear indications for hand disinfection in its “5 Moments for Hand Hygiene”:¹

  1. Before touching a patient
  2. Before clean/aseptic procedures
  3. After body fluid exposure/risk
  4. After touching a patient
  5. After touching patient surroundings

Alcohol-based hand rub is regarded as the gold standard because it acts quickly, is well tolerated and is effective against most relevant pathogens.

Studies show that consistent hand hygiene significantly reduces healthcare-associated infections – including those involving multidrug-resistant organisms.

Surface disinfection and environmental management

Alongside hands, patient-near surfaces also play a central role:

  • bed rails
  • bedside tables
  • door handles
  • medical equipment
  • sanitary facilities

Resistant pathogens can persist on surfaces for hours or even days in some cases.²

Regular, validated surface disinfection using suitable, tested disinfectants is therefore essential.

Key requirements include:

  • correct contact times
  • suitable active substance classes
  • trained staff
  • structured cleaning schedules

Protective clothing as a barrier against cross-contamination

Protective clothing interrupts chains of transmission between staff, patients and the environment.

Key elements include:

  • single-use gloves
  • protective gowns
  • face masks / medical masks
  • FFP masks where applicable
  • overshoes or hair protection in certain areas

Single-use gloves reduce the risk of direct pathogen transmission, but never replace hand disinfection. They should be understood as an additional barrier.

Particularly when dealing with multidrug-resistant organisms or during isolation measures, compliant, quality-tested protective clothing is indispensable.

For example, medical single-use gloves should meet at least the requirements of EN 455 (medical devices) and – depending on the area of use – additionally be certified as PPE to EN ISO 374.

Similarly, protective gowns must comply with the requirements of the MDR or the PPE Regulation depending on risk classification.

Structured isolation and prevention measures

When multidrug-resistant organisms are detected, additional measures are implemented:

  • contact precautions
  • single-room accommodation
  • cohort isolation
  • dedicated equipment
  • clear labelling and training

Such structured concepts are defined in national guidelines, for example by the RKI.

Why prevention is more effective than new antibiotics

The development of new antibiotics is time-consuming, costly and scientifically complex. At the same time, bacteria will sooner or later develop resistance even to new agents.

Hygiene, by contrast, works immediately – regardless of the resistance mechanism.

Every prevented infection means:

  • no antibiotic use
  • no additional selective pressure
  • no onward transmission of resistant pathogens

That is why modern infection prevention follows a simple principle:

Hygiene protects against resistance.

Quality and standardisation as success factors

Effective hygiene measures are based on:

  • certified products
  • standards-compliant manufacturing
  • documented quality assurance
  • trained staff
  • clear process workflows

Particularly in facilities with high patient density and vulnerable groups, the combination of validated disinfection, appropriate protective clothing and consistent implementation is critical for patient safety.

The next section therefore takes a closer look at the role single-use products – especially gloves, protective gowns and masks – play in practical infection prevention, and why their appropriate selection and quality are relevant for resistance control.

Single-use products in infection prevention: barriers against cross-contamination

Single-use products are a core component of modern hygiene concepts. Their objective is clearly defined: to break chains of transmission and prevent cross-contamination.

Especially in the context of antibiotic-resistant pathogens, the correct selection and use of disposable products is of particular importance.

Why single-use instead of reusable?

Reusable products are not inherently problematic – provided they are reprocessed correctly. In practice, however, there are risks due to:

  • inadequate cleaning
  • errors in disinfection
  • faulty sterilisation
  • organisational gaps

Single-use products, by contrast, are discarded after one use. This eliminates the risk of incomplete reprocessing.

Especially for:

  • contact isolation
  • invasive procedures
  • wound care
  • handling multidrug-resistant organisms

the use of disposable products is an established prevention tool.

Single-use gloves – a systematic barrier

Medical single-use gloves reduce the direct transmission of germs between staff and patients.

However, it is important that:

  • Gloves never replace hand disinfection.
  • They must be used according to indication.
  • They must comply with the applicable standards.

For medical use, the following are particularly relevant:

  • EN 455 (Parts 1–4) – requirements for medical single-use gloves
  • EN ISO 374 – protection against chemicals and micro-organisms
  • Classification under the MDR (EU 2017/745)

For example, facilities commonly use:

Surface management and supplementary hygiene solutions

Alongside personal protective equipment, other single-use products also play a role:

  • single-use aprons
  • sleeve protectors
  • examination couch covers
  • dispenser and dispensing systems

A structured material flow supports compliance with hygiene standards.

Quality as a safety factor

Not every single-use product automatically provides adequate protection. Decisive factors include:

  • CE marking
  • MDR or PPE conformity
  • tested material thicknesses
  • documented AQL values
  • traceability
  • controlled supply chain

Especially in the context of antibiotic-resistant pathogens, no compromises should be made on material quality or standards compliance.

Single-use products as part of an overall system

Single-use products do not work in isolation, but in combination with:

  • disinfection measures
  • training
  • antibiotic stewardship
  • surveillance systems

When selected appropriately and used correctly, they are an effective instrument for interrupting infection chains – and therefore an indirect but crucial contribution to curbing antibiotic resistance.

The next section therefore explains how rational antibiotic use – within the framework of so-called antibiotic stewardship – additionally contributes to resistance control.

Antibiotic stewardship: using antibiotics in a targeted and responsible manner

Alongside hygiene and infection prevention, the rational use of antibiotics is the second central pillar in the fight against resistance. This structured approach is summarised under the term antibiotic stewardship (ABS).

The aim is to use antibiotics only when indicated, as targeted as possible and for as short a duration as medically necessary – without compromising patient safety.

What does antibiotic stewardship mean?

Antibiotic stewardship describes a systematic concept for optimising anti-infective therapy.

Key objectives are:

  • Improving the quality of therapy
  • Reducing unnecessary antibiotic administration
  • Minimising adverse effects
  • Slowing the development of resistance
  • Reducing healthcare-associated infections

In Germany, ABS is supported, among other things, by recommendations from the RKI and AWMF guidelines.

Diagnostics before therapy

A core principle is:

“Test first, then treat – where possible.”

Before starting antibiotic therapy, microbiological samples should be taken – where clinically justifiable:

  • blood cultures
  • urine cultures
  • swabs
  • wound samples

This allows the pathogen to be identified and treated with a narrow-spectrum antibiotic, rather than immediately using a broad-spectrum agent.

Broad-spectrum antibiotics significantly increase selective pressure and promote resistance development.

The right substance, dose and duration

Another key ABS principle is optimising:

  • choice of agent
  • dosage
  • duration of therapy

Therapies that are too short can be ineffective – unnecessarily long therapies, by contrast, increase resistance development and the rate of adverse effects.

Modern ABS programmes often recommend:

  • early re-evaluation after 48–72 hours
  • de-escalation when the pathogen has been identified
  • switching to oral therapy where possible

Interdisciplinary ABS teams

Many hospitals have structured ABS teams consisting of:

  • infectious disease specialists
  • microbiologists
  • hospital pharmacists
  • infection prevention and control specialists
  • treating physicians

These teams monitor antibiotic prescribing, analyse resistance data and advise clinical departments.

Studies show that structured ABS programmes:

  • reduce antibiotic consumption
  • reduce resistance rates
  • can improve treatment outcomes.¹

The link between ABS and hygiene

Antibiotic stewardship and hygiene are not separate concepts – they complement one another.

  • Hygiene prevents infections → less need for antibiotics
  • ABS reduces unnecessary antibiotic use → less selective pressure

Together, they form an effective protection system against the spread of multidrug-resistant organisms.

The One Health approach

Resistance development is not confined to hospitals.

The so-called One Health approach takes into account:

  • human health
  • animal health
  • agriculture
  • the environment

Antibiotic use in livestock farming can also promote resistance genes that reach humans via food chains or environmental pathways.

International organisations such as WHO, FAO and OIE therefore emphasise cross-sector collaboration.

Why stewardship is decisive in the long term

The development of new antibiotics is scientifically complex and economically unattractive. At the same time, bacteria continuously adapt.

A sustainable approach to existing agents is therefore essential.

Antibiotics are a finite resource – preserving them requires structured action.

The next section looks at the global dimension of the resistance problem – from environmental factors to surprising scientific findings from extreme habitats.

One Health: the environment, livestock farming and a look into the ice cave

Antibiotic resistance does not arise exclusively in hospitals. It is the result of a complex interplay between human medicine, veterinary medicine, the environment and global mobility. This holistic understanding is referred to as the One Health approach.

One Health means that the health of people, animals and the environment is inextricably linked.

Resistance genes in the environment

Antibiotics and resistant bacteria enter the environment via various routes:

  • excretions from treated patients
  • hospital wastewater
  • residues from livestock farming
  • industrial effluent from pharmaceutical manufacturing
  • manure application in agriculture

Wastewater treatment plants can remove many, but not all, antibiotic substances or resistance genes completely. This creates additional selective pressure on environmental bacteria in water bodies and soils.

Resistance genes can accumulate in microbial communities and later transfer back into pathogenic germs.

Livestock farming and food chains

In livestock farming, antibiotics are used to treat bacterial diseases. Even though use in Europe has been more tightly regulated and reduced in recent years, veterinary medicine remains a relevant factor in resistance dynamics.

Resistant germs can be transmitted to humans:

  • through direct animal contact
  • through meat products
  • via environmental routes

That is why international strategies – for example from WHO, FAO and WOAH – pursue a cross-sector approach to reducing antibiotic use.

Global mobility

Travel, medical tourism and international supply chains contribute to the worldwide spread of resistant pathogens.

Resistance is not a local problem. A multidrug-resistant germ that emerges in one country can spread across continents within a matter of days.

The resistant bacterium from the ice cave

A particularly striking example of the topic’s complexity came from a study in which researchers were able to detect resistance genes in permafrost that is thousands of years old.¹

In samples from isolated cave and permafrost regions, genes were identified that resemble today’s resistance mechanisms – long before humans developed antibiotics.

What does this mean?

Resistance is not purely a modern phenomenon. For millions of years, bacteria have produced natural antibiotics to compete with one another. Other bacteria developed protective mechanisms in response.

What is new, however, is the speed at which resistance spreads today.

Through mass antibiotic use and global interconnectedness, humans have created immense selective and dissemination pressure.

The “bacterium from the ice cave” therefore shows two things:

  1. Resistance is evolutionarily embedded.
  2. Today’s global rise is accelerated by human activity.

Climate change as an additional factor

More recent studies suggest that rising temperatures may favour the growth of certain bacteria and could influence the spread of resistant germs.²

In addition, thawing permafrost soils could release previously trapped micro-organisms – a research field currently being intensively investigated.

Why prevention must be cross-sector

The resistance problem therefore cannot be solved in hospitals alone.

What is required is:

  • rational antibiotic use in human and veterinary medicine
  • functional wastewater systems
  • global surveillance systems
  • hygiene standards in facilities
  • international cooperation

Antibiotic resistance is a global ecosystem problem – with local impacts on every single healthcare facility.

The next section looks to the future: which research approaches and innovations could help slow resistance development or create new therapeutic options?

Research and the future: new approaches to tackling antibiotic resistance

Combating antibiotic resistance requires more than prevention and the rational use of existing agents. Worldwide, intensive research is being conducted into new therapeutic approaches, diagnostic methods and technological solutions.

At the same time, it is becoming clear that there will be no single “miracle solution”. Rather, a bundle of innovation, structural measures and global cooperation is necessary.

New antibiotics – limited but important progress

In recent years, a small number of new agents have been approved, particularly against multidrug-resistant Gram-negative pathogens. However, these are often modifications of existing substance classes.

Developing new antibiotic classes is difficult for several reasons:

  • high research and development costs
  • short duration of use (antibiotics are not taken long term)
  • low economic attractiveness compared with chronic therapies
  • rapid development of resistance

International initiatives are therefore seeking to create incentive models for antibiotic research.

Phage therapy – viruses against bacteria

A frequently discussed approach is phage therapy.

Bacteriophages are viruses that specifically infect and destroy bacteria. Unlike antibiotics, they act very specifically – often only against particular bacterial strains.

Potential advantages:

  • targeted control of resistant pathogens
  • less disruption of the natural microbiota
  • an alternative option for treatment-resistant infections

Challenges remain in standardisation, regulatory classification and rapid adaptation to mutating bacteria.

Vaccines as indirect resistance prevention

Vaccinations reduce bacterial infections – and therefore also the need for antibiotics.

A well-known example is pneumococcal vaccination. After its introduction, several countries observed a decline in antibiotic-resistant pneumococci.

Vaccination strategies are therefore regarded as an indirect but highly effective measure for resistance control.

Faster diagnostics

A key practical issue is the time to pathogen identification. Conventional microbiological cultures often require 24–72 hours.

Modern developments include:

  • molecular rapid tests
  • PCR-based methods
  • point-of-care diagnostics
  • genomic resistance analysis

The faster a pathogen is identified, the more targeted therapy can be – and the sooner unnecessary broad-spectrum antibiotics can be avoided.

Artificial intelligence in resistance research

AI-supported systems are increasingly used to:

  • identify new drug structures
  • predict resistance patterns
  • support treatment decisions
  • analyse surveillance data

In the future, these technologies could help detect resistance trends earlier and implement countermeasures more quickly.

Why prevention remains the most important factor

Despite all innovation, one point remains:

No research approach can solve the global resistance problem in the short term.

New antibiotics will – like their predecessors – sooner or later encounter resistant germs. That is why:

  • consistent hygiene
  • structured disinfection
  • standards-compliant protective clothing
  • antibiotic stewardship
  • international cooperation

remain the pillars of resistance control.

Research expands the options – prevention safeguards the present.

The final section therefore summarises which measures are already effective today and why facilities carry particular responsibility.

Conclusion: containing resistance through prevention and responsibility

Antibiotic resistance is not a distant future scenario, but a reality already felt today. Millions of infections worldwide are associated with resistant pathogens. Modern medicine – from routine operations to intensive care – depends on effective antibiotics.

The causes are scientifically well understood:

  • selective pressure from antibiotic use
  • transmission in healthcare facilities
  • global mobility
  • environmental and livestock-related factors
  • inadequate prevention measures

At the same time, it is clear that resistance arises evolutionarily – but its speed and spread are significantly influenced by human behaviour.

Facilities carry a particular responsibility

Hospitals, care homes and outpatient care structures are key interfaces in resistance dynamics.

Every day, it is decided:

  • whether infections are prevented,
  • whether antibiotics are used rationally,
  • whether hygiene standards are implemented consistently.

Consistent hand hygiene, structured surface disinfection, standards-compliant protective clothing and quality-assured single-use products are not box-ticking exercises – they are concrete measures to break chains of infection.

Every prevented infection reduces the need for antibiotics.
Every avoided antibiotic dose lowers selective pressure.

Prevention has an immediate – and lasting – effect.

Antibiotics are a finite resource

The development of new agents can scarcely keep pace with bacteria’s ability to adapt. Responsible use of existing antibiotics is therefore essential.

Antibiotic stewardship programmes, surveillance systems and the One Health approach show that the solution lies in structured, interdisciplinary action.

A realistic but constructive outlook

The resistant bacterium from permafrost that is thousands of years old has shown that resistance is not a new phenomenon.

What is new, however, is the global dynamic – and therefore the global responsibility.

The good news:

We already have effective instruments today:

  • evidence-based hygiene standards
  • tested disinfection procedures
  • standards-compliant protective products
  • structured antibiotic strategies
  • international cooperation

Antibiotic resistance is a silent crisis – but not an uncontrollable one.

With consistent prevention, high-quality equipment and responsible antibiotic use, its momentum can be significantly slowed.

References

Below you will find the scientific and institutional sources used in the article, as well as additional references relevant to the topic. The selection is based on internationally recognised specialist institutions and peer-reviewed publications.