Antimicrobial resistance (AMR) has become one of the most urgent global health crises, as highlighted by Theodore Rosen, MD, in his impactful session, "Topical and Systemic Antibiotic Therapy." Dr Rosen opened with a case of a Serratia marcescens infection following a cat bite, which ultimately led to a finger amputation despite aggressive antibiotic treatment, showcasing the severe consequences of resistant pathogens. He stressed that AMR is a present and growing challenge, driven by the overuse and misuse of antibiotics, the adaptability of microbes, and a stalled pipeline for new drug development. With 1.3 million deaths attributed to AMR in 2019 and projections reaching 2 million annually by 2050, the presentation shed light on resistance mechanisms, such as efflux pumps and enzymatic degradation, and the diminishing arsenal of effective therapies.

Dr Rosen emphasized the necessity of antibiotic stewardship, urging clinicians to ensure accurate diagnoses, select appropriate therapies, and minimize treatment durations. He also explored innovative solutions to combat AMR, including bacteriophages, antimicrobial antibodies, AI-driven drug discovery, and vaccine development. Expanding beyond bacterial resistance, Dr Rosen highlighted the growing threats from resistant viruses, fungi, and parasites, such as acyclovir-resistant HSV and terbinafine-resistant dermatophytes. Concluding with a call to action, he underscored the need for global collaboration, innovation, and vigilance to avoid a post-antibiotic era where even routine infections could become life-threatening. This session served as a critical reminder of the pressing need to address AMR through multidisciplinary efforts and cutting-edge research.