A one health nanotechnology approach to address antimicrobial resistance: state-of-the-art and strategic outlook

Antimicrobial resistance (AMR) has emerged as a critical global health threat, driven by the rapid evolution and dissemination of resistance mechanisms among pathogens, and exacerbated by the interconnectedness of human, animal, and environmental health sectors. This review provides a comprehensive synthesis of the mechanisms underlying AMR including membrane permeability modification, efflux pumps, enzymatic inactivation, and target site modification while framing the crisis within the One Health perspective that emphasizes cross-sectoral collaboration and holistic strategies. The article systematically evaluates current approaches to combating AMR, such as novel drug discovery, combination therapies, bacteriophage-based interventions, antimicrobial adjuvants, and antimicrobial peptides, highlighting their respective strengths and limitations. The core of the review focuses on the advances in nanotechnology-based strategies, detailing the antimicrobial potential of diverse nanomaterials including chitosan, poly(lactic-co-glycolic acid) (PLGA) nanoparticles, liposomes, solid lipid nanoparticles, metal and metal ion nanoparticles (e.g., zinc oxide, silver, copper, gold, titanium, magnetic, cobalt), carbon dots, dendrimers, and hydrogels. Special attention is given to their mechanisms of action, efficacy against multidrug-resistant organisms, and applicability across human, veterinary, and environmental contexts. Moreover, the review addresses the limitations of nanotechnology-based approaches, such as nanoparticle cytotoxicity, the potential for nanoparticle-induced resistance, and the toxicological and ecological risks posed to One Health ecosystems. By critically appraising these challenges, the review identifies key research gaps and regulatory hurdles that must be overcome to enable the safe and effective clinical translation of nano-antimicrobials. The article concludes by outlining future prospects for the field, advocating for interdisciplinary research, responsible stewardship, and innovative policy frameworks to sustain the fight against AMR and protect global health.