Antibiotic resistance is making some infections harder to treat across the European Union, with consequences for patients, healthcare systems, animals and the environment. Researchers and public-health specialists say the response must extend beyond developing new medicines and address how resistance spreads across human, animal and environmental health.
Antimicrobial resistance, or AMR, is estimated to be associated with around 35,000 deaths each year in the EU. The threat is not limited to hospitals: antibiotic use, sanitation, wastewater, farming practices and pollution can all influence how resistant bacteria emerge and circulate.
Why antibiotic resistance is a growing European health concern
Antibiotics have transformed medicine by allowing doctors to treat bacterial infections that were once frequently fatal. They also make many routine procedures safer, including surgery, cancer treatment and care for people with weakened immune systems.
Resistance develops when bacteria evolve in ways that allow them to survive medicines intended to eliminate them. Resistant bacteria can then multiply and spread. Infections caused by multidrug-resistant organisms may require several medicines at once, longer hospital stays and more complicated treatment. In some cases, available combinations may not work.
The scale of the problem is expected to increase. A study published in The Lancet projects that bacterial AMR could directly cause 39 million deaths worldwide between 2025 and 2050. That is a global projection, rather than a forecast for the EU alone, but it illustrates why antimicrobial resistance has become a major public-health priority.
How resistance spreads between people, animals and the environment
Resistance is often discussed as a medical issue, but bacteria and the genetic material that gives them resistance can move between different parts of the ecosystem. This has led researchers and policymakers to promote the One Health approach.
One Health recognises that human health is connected to animal health and environmental conditions. Resistant bacteria may circulate through healthcare settings, communities, farms, food systems and waterways. Antibiotic use in people and animals can create conditions in which resistant organisms survive, while inadequate sanitation and environmental contamination can help them spread.
- Human health: Unnecessary or inappropriate antibiotic use can increase selective pressure on bacteria.
- Animal health: Resistant organisms can move through livestock, food chains and agricultural environments.
- Environmental health: Wastewater and pollution can carry bacteria or resistance genes into rivers and other ecosystems.
This wider perspective means that tackling AMR requires cooperation between doctors, veterinarians, farmers, environmental scientists, regulators and public-health authorities.
Prevention is as important as new antibiotics
Developing new antibiotics remains important, particularly for infections that no longer respond to existing treatments. However, new medicines alone cannot solve the problem if resistance continues to spread or if antibiotics are overused.
Vaccination is one potential part of the solution. By preventing bacterial infections, or infections that can lead to secondary bacterial complications, vaccines can reduce the need for antibiotic treatment. The World Health Organization estimates that improved vaccine use could reduce global antibiotic consumption by 2.5 billion doses each year.
Prevention also includes timely diagnosis, effective infection-control measures and access to appropriate healthcare. Protecting older people and those with weakened immune systems is especially important because they can face a higher risk of serious infection.
Public-health experts also caution against treating all bacteria as harmful. Beneficial bacteria live in the gut, on the skin and elsewhere in the body, where they contribute to normal health and may help limit the growth of harmful organisms. Excessive or inappropriate use of antibiotics and disinfectants can disrupt these natural microbial communities.
What a One Health response could involve
A coordinated European strategy would combine responsible prescribing with action across agriculture, environmental protection and public health. Measures may include:
- Improving testing so patients receive the right treatment and antibiotics are not used unnecessarily.
- Strengthening infection prevention in hospitals, care settings and communities.
- Increasing vaccination coverage where vaccines can prevent infections and reduce antibiotic demand.
- Monitoring resistance in people, animals, food systems and the environment.
- Improving wastewater treatment and reducing the release of medicines and resistant bacteria.
- Supporting animal health and responsible antibiotic use throughout the food chain.
- Investing in research into antibiotics, vaccines and alternative treatments.
These measures require sustained funding and cooperation rather than a single emergency intervention. Surveillance is also essential because health authorities need reliable information about which bacteria are becoming resistant, where they are spreading and which treatments remain effective.
What the threat means for Ireland
Ireland is part of the EU-wide public-health challenge, while research and expertise at Irish institutions contribute to understanding antimicrobial resistance. The issue affects hospitals, community healthcare, agriculture, food production and environmental management.
For patients, responsible antibiotic use means taking medicines only when prescribed for a bacterial infection and following professional instructions. Antibiotics do not treat viral illnesses such as most colds and flu. Decisions about treatment should always be made with a qualified healthcare professional.
Ireland’s response also depends on cooperation between health services, laboratories, veterinary authorities, farmers, universities and environmental agencies. Because resistant bacteria do not respect national borders, monitoring and information-sharing across the EU remain important.
What happens next
Antimicrobial resistance is not a problem that can be solved solely by discovering a replacement for every antibiotic that loses effectiveness. The evidence points to a layered response: prevent infections, use medicines carefully, protect beneficial microbial communities, improve sanitation and monitor the movement of resistant bacteria.
The central lesson of the One Health approach is that decisions made in healthcare, farming and environmental policy can influence one another. For Europe, reducing the superbug threat will depend on maintaining that connection and turning it into coordinated, long-term action.