Multidrug-resistant (MDR) infections have emerged as a critical threat to global health, particularly within clinical settings where they contribute to increased morbidity, mortality, and healthcare costs. The overuse and misuse of antibiotics have accelerated the evolution of resistant strains. Bacteria have developed sophisticated mechanisms to evade antimicrobial agents, including the ability to form biofilms—structured communities of microorganisms encased in a protective matrix. Biofilms not only shield bacteria from antibiotics but also facilitate horizontal gene transfer, promoting the spread of resistance genes. The complexity of MDR infections necessitates a multifaceted approach to understand the interplay between antibiotic prescribing patterns, resistance development, and biofilm formation.

The goal of this collection is to address the escalating challenge of multidrug resistance by exploring factors contributing to the emergence and persistence of MDR pathogens in clinical environments. Specifically, we aim to analyze antibiotic usage patterns by examining how prescribing habits influence resistance development and identifying trends correlating with increased MDR pathogen incidence. Additionally, we evaluate antibiotic stewardship programs to assess the effectiveness of current initiatives, including carbapenem-sparing strategies, in curbing misuse and reducing resistance rates. We also investigate biofilm-associated resistance to understand the role of biofilm formation in protecting bacteria from antibiotics and the immune system, exploring novel approaches to disrupt or prevent biofilms. Furthermore, we advance monitoring and combating strategies by highlighting recent methodologies and technologies for promptly and accurately detecting MDR infections, while discussing innovative treatments and interventions. By bringing together recent advances and diverse research perspectives, this collection seeks to identify actionable insights that enhance clinical practices and guide policy-making to mitigate the threat of MDR infections.

We invite contributions that offer significant insights into multidrug resistance, focusing on but not limited to the following themes:
• Antibiotic Prescribing Practices: Studies analyzing the impact of antibiotic use—such as duration, dosage, and spectrum—on the development of resistance in clinical isolates.
• Pathogen-Specific Resistance Mechanisms: Research on mechanisms employed by P. aeruginosa, A. baumannii, S. maltophilia and other MDR organisms to resist antibiotics.
• Biofilm Dynamics and Disruption: Investigations into biofilm role in resistance, and novel strategies (chemical, mechanical, or biological) to prevent or disrupt biofilms.
• Effectiveness of Stewardship Programs: Evaluations of current antibiotic stewardship efforts, barriers to implementation, and proposals for enhancing impact on MDR trends.
• Carbapenem-Sparing Therapies: Exploration of alternative treatments to carbapenems, including new antibiotics, combination therapies, and non-antibiotic approaches.
• Diagnostic and Surveillance Innovations: Development and assessment of cutting-edge tools for rapid detection and monitoring of MDR pathogens.
• Policy and Ethical Considerations: Discussions on the ethical implications of antibiotic use, policy analysis of current regulations, and recommendations for policy reforms to address MDR challenges.

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Frontiers in Antibiotics

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