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Poor access to reliable diagnostic tests can leave clinicians choosing antibiotics without knowing which infection they are treating. That can make treatment less targeted and deprive health systems of dependable information about where resistance is spreading. Better diagnostics are an important part of the response—but tests alone cannot stop antibiotic resistance.
How can poor diagnostics contribute to antibiotic resistance?
Diagnostics help clinicians determine whether symptoms are caused by a bacterial infection, identify the pathogen, and, where testing allows, learn which antibiotics are likely to work. When testing is unavailable, delayed, unaffordable, or unreliable, clinicians may have to start treatment based on symptoms and clinical judgment alone. That can mean giving antibiotics when they are not needed, or choosing a medicine that does not work against the infection.
Antibiotics do not treat viral infections, and taking antibiotics unnecessarily or using them inappropriately contributes to antimicrobial resistance (AMR). Infections that are not treated effectively can also require further care and different medicines. The World Health Organization (WHO) identifies misuse and overuse of antibiotics as major drivers of AMR. Diagnostics can support better decisions, but their effect depends on whether results are timely and trustworthy and whether clinicians can act on them.
What does the latest resistance evidence show?
WHO reported that in 2023, one in six laboratory-confirmed bacterial infections causing common infections worldwide were resistant to antibiotic treatments. This describes infections included in surveillance, not every infection or every person with an infection.
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Resistance also varies by region. In WHO’s reported 2023 data, one in three reported infections in the South-East Asian and Eastern Mediterranean Regions and one in five in the African Region were resistant. WHO says resistance is more common and worsening where health systems lack capacity to diagnose or treat bacterial pathogens.
Across monitored pathogen–antibiotic combinations, resistance rose in more than 40% between 2018 and 2023. WHO reported an average annual increase of 5–15% for those combinations. These figures describe the monitored combinations, not a uniform increase across all bacteria, antibiotics, or locations.
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Why does the testing bottleneck matter in clinics?
A test is useful only if a patient can access it, the laboratory can produce a reliable result, and the result arrives in time to guide care. Weak laboratory capacity, cost, geographic barriers, and limited use of available tests can all leave treatment decisions dependent on empirical prescribing—choosing treatment before the cause is confirmed.
The UK Government’s 2019–2024 action plan described most antibiotic prescribing, supply, and administration at the time as occurring without information about the nature of the infection. It said tests for most bacterial infections then took approximately 48 hours to yield results, contributing to empirical treatment that could be wrong or unnecessary. That is a historical, UK-plan-specific assessment, not a current or universal turnaround time: testing speed varies by test, pathogen, laboratory, and setting.
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Even when an individual patient receives appropriate testing, the result is only part of the response. Clinicians need access to suitable medicines and guidance, while health systems need infection prevention, stewardship, and reliable information to detect patterns and respond to outbreaks.
Why are diagnostics also essential for resistance surveillance?
Laboratory testing generates evidence about which pathogens are circulating and which antibiotics are losing effectiveness. Aggregated, dependable results help public-health teams monitor trends, investigate outbreaks, and inform treatment guidance and policy. If tests are not available in underserved areas, or laboratories cannot generate reliable results, surveillance can miss important parts of the picture.
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WHO’s 2025 surveillance release reported that 104 countries contributed data to the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2023, up from 25 in 2016. But participation did not mean complete, dependable coverage: 48% of countries did not report data to GLASS in 2023, and about half of reporting countries lacked systems to generate reliable data.
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WHO’s AMR Diagnostic Initiative builds on the 2023 World Health Assembly resolution WHA76.5 on strengthening diagnostic capacity. Its stated goal is equitable access to quality testing for bacterial, fungal, and resistant pathogens throughout health systems and in communities. The initiative treats laboratory capacity as a system to build, rather than a matter of supplying test equipment alone.
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- Global AMR Laboratory Network: strengthen connections between laboratories and support coordinated surveillance.
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WHO’s 27 June 2024 policy brief says the initiative aims to bring diagnostics to the forefront of the AMR response and support microbiology laboratory capacity and equitable access to quality testing. Its scope includes bacterial and fungal pathogens as well as resistant pathogens, at all levels of the health system and in the community.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Why better tests must be paired with stewardship
Testing can help clinicians avoid unnecessary antibiotics and select treatment more appropriately, but it cannot determine every prescribing decision or ensure that results lead to action. Responsible antibiotic use, infection prevention, access to appropriate medicines, and stronger health-system capacity remain necessary parts of AMR control.
WHO’s antimicrobial resistance fact sheet reports that Access antibiotics accounted for 53% of global human antibiotic use in 2022, below the 2030 target of at least 70%. The Access category is part of WHO’s antibiotic-use classification; this figure is not a measure of diagnostic coverage or proof that changing antibiotic use alone will reverse resistance.
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WHO Director-General Dr Tedros Adhanom Ghebreyesus put the linked priorities this way in a 13 October 2025 WHO news release: “As countries strengthen their AMR surveillance systems, we must use antibiotics responsibly, and make sure everyone has access to the right medicines, quality-assured diagnostics, and vaccines.”
Quick Recap
What better diagnostics can—and cannot—do
- They can: help distinguish infection types, guide treatment choices, support antimicrobial stewardship, and provide data for surveillance and outbreak response.
- They cannot do on their own: guarantee appropriate prescribing, make a result available where laboratories are weak or inaccessible, or replace infection prevention and access to effective medicines.
- The evidence does not quantify: the independent effect of expanding diagnostic access on later resistance rates. The case for better diagnostics is supported by their role in clinical management and surveillance, not by a specific measured reduction in resistance attributable to testing alone.
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