The Antibiocene – towards an eco-social analysis of humanity's antimicrobial footprint

Our biosphere is rapidly changing. In the case of microbial environments, the rise of antimicrobial resistance (AMR) across a wide number of bacterial species is a significant genetic and phenotypic marker of humanity’s growing planetary footprint. Although phylogenetic studies indicate that many genetic traits conferring AMR predate the antimicrobial era, the rapid rise in the release of antimicrobial substances such as pharmaceuticals, heavy metals, and biocides from the 19th century onwards has played a significant role in accelerating this “Anthropocene in the cell.” Researchers, policymakers, and journalists have responded to the ongoing acceleration of AMR burdens with increasingly vocal calls for antimicrobial stewardship and drug innovation to avert a pending “antibiotic apocalypse” when essential drugs no longer work. But what if the alleged apocalypse is already upon us—just not as a Hollywood-style catastrophic systems collapse—but as an increasingly apparent degradation of the microbial commons humanity relies on? If a return to an era of microbial sensitivity is not possible both because of the inbuilt antimicrobial dependency of our food and medical infrastructures as well as the genetic legacy antimicrobial exposures have already created in our biosphere, it is time to focus on what life amongst the detritus of the antimicrobial era—the Antibiocene—looks like. Abandoning the apocalyptic genre that has grown up around AMR debates is neither defeatist nor does it remove the need for urgent action to prevent deaths from priority pathogens or ongoing stewardship efforts. Instead, it is to contextualise and orientate ad hoc mitigation efforts within a more long-term analytical eco-social framework of constantly evolving human-microbial interactions. In this thought piece, the author first reviews existing attempts to make sense of the unintended fallouts of our antimicrobial era and the inherent limitations of traditional portrayals of AMR as a short-termist challenge of treatment failure and individual responsibility. The article then argues that engaging with AMR as a major signal of an unfolding planetary Anti-biocene opens the door for integrating ongoing social sciences, environmental humanities, and biomedical research on the various scales and fallouts of antimicrobial exposures and microbiota shifts. Finally, it proposes comparative research on sites of chronic antimicrobial hyper-exposure to untangle the biosocial dynamics of the Antibiocene and inform debates on fostering balanced eubiotic microbiota.

The paper situates AMR within a long history of awareness and policy responses. It notes recognition of drug fastness since ca. 1910, rapid reports of sulfonamide resistance by the late 1930s, and mid-20th-century warnings (e.g., René Dubos) about ecosystem destabilisation from mass antimicrobial use. Despite growing evidence, policy attention since the 1950s has largely focused on immediate clinical and productivity threats, leading to short-termist stewardship and innovation frames. A review of 248 international AMR policy reports (since 1950) found only two that explicitly focused exclusively on the environmental domain of One Health; analyses of the 2015 WHO Global Action Plan showed only a minority of proposals targeted environmental issues. The article synthesizes environmental AMR research indicating widespread antimicrobial exposures across terrestrial and aquatic systems, the cumulative spread of ARGs (including remote environments), and evidence of selection at even low antimicrobial concentrations. It also reviews social science and environmental humanities scholarship on risk distribution, slow violence, and inequalities, applying these to antimicrobial exposures and AMR.

- Proposes and substantiates the concept of the Antibiocene: a new geological era signaled by planetary-scale, cumulative antimicrobial exposures and resultant microbial genomic and phenotypic shifts (notably AMR). - Documents pervasive environmental antimicrobial exposures: high selective concentrations detected in Chinese city tap water (2014 survey) and in 258 rivers worldwide (representing 471.4 million people), with levels exceeding industry-set safety thresholds on all continents (Wilkinson et al., 2022). Even very low concentrations can select for AMR. - Shows global dissemination and accumulation of antimicrobial resistance genes (ARGs): ARGs detected from Antarctic environments to uncontacted human microbiomes and clouds; archived Dutch soils show significant increases in AMR gene alleles since 1940, including >15-fold increases for some tetracycline resistance alleles between 1970 and 2008. - Highlights temporal dynamics of microbial evolution: ultra-rapid microbial generation times and frequent horizontal gene transfer drive swift adaptation under anthropogenic selection pressures. - Reveals policy and governance gaps: entrenched focus on clinical and veterinary domains and pharmaceutical use, with environmental pathways under-addressed (only 2 of 248 international AMR reports focused exclusively on environment). - Emphasizes inequalities: ARG prevalence correlates with regional antibiotic usage per capita; social determinants (WASH, healthcare, nutrition) create uneven exposure and vulnerability, resulting in a “stacking of lacks.” Wealthier regions mitigate risks via access to reserve drugs, infection control, antibiotic-free supply chains, or outsourcing pollution. - Introduces ‘eubiotic governance’: advocates moving beyond emergency efficacy preservation toward long-term stewardship of microbial commons across One Health, integrating dysbiosis mitigation, environmental controls, and justice considerations. - Research agenda: calls for comparative, longitudinal studies of hyperexposed sites (e.g., landfills, hospital/animal operation effluents, pharmaceutical manufacturing) to map biochemical decay, ARG/mobility element dynamics, microbiota shifts, and societal adaptations.

By reframing AMR as a signal of the Antibiocene, the paper addresses the limitations of short-term, clinic-centered narratives of ‘therapy failure’ and situates AMR within broader, multi-scalar eco-social processes. This perspective ‘inscales’ the Anthropocene by attending to microbial temporalities and the rapid, measurable genomic/ecological changes under anthropogenic selection. It clarifies how cumulative exposures across terrestrial, aquatic, and built environments reshape microbial communities, linking environmental pollution, co-selective agents, and microbial evolution to clinical outcomes. The framework redirects attention to the neglected environmental domain of One Health, underscores the need for structural interventions that address infrastructures and exposures (pharmaceutical and non-pharmaceutical), and integrates justice by foregrounding uneven risks and capabilities for mitigation. It proposes eubiotic governance to manage dysbiosis and preserve microbial diversity/function across systems, recognizing trade-offs and the impossibility of returning to a pre-antibiotic state. Comparative study of hyperexposed sites is advanced as a practical means to decode spatiotemporal dynamics of exposures/ARGs, identify points of acceleration, and inform targeted, context-sensitive remediation and stewardship policies.

The article contributes a unifying eco-social framework—the Antibiocene—to interpret AMR as a planetary marker of anthropogenic antimicrobial exposures and to guide policy beyond preserving drug efficacy. It synthesizes evidence of pervasive, cumulative exposures and ARG dissemination, critiques policy neglect of environmental pathways, and advances ‘eubiotic governance’ to manage microbial commons across One Health with attention to inequality and slow violence. It calls for interdisciplinary, comparative longitudinal research of hyperexposed sites to reconstruct biochemical, genomic, and societal trajectories, identify acceleration points, and inform remediation and stewardship that acknowledge irreversible changes and local contexts. Future research should integrate genomic, ecological, biochemical, archaeological, and historical data; quantify long-term exposure dynamics and bioavailability; assess thresholds for accelerated adaptation; and evaluate justice-centered interventions that balance microbial eubiosis across communities and environments.

This is a conceptual thought piece without original empirical data or formal methodology. It synthesizes existing literature and proposes frameworks and research agendas. The paper acknowledges limited systematized, long-term environmental AMR data, difficulties in linking environmental reservoirs conclusively to human/animal health outcomes, and challenges in translating environmental AMR evidence into policy.