The introduction of antibiotics revolutionized medicine, saving countless lives, but the development of antibiotic resistance has been relentless. The complexity of resistance mechanisms and the lack of basic knowledge have hindered effective prevention and control. Antibiotic resistance is particularly prominent in bacteria, with multidrug-resistant (MDR) strains causing significant morbidity and mortality. The discovery and introduction of antibiotics, such as penicillin and streptomycin, have been followed by the rapid emergence of resistant strains. The genetic and ecological aspects of resistance are crucial, with horizontal gene transfer (HGT) playing a significant role in the dissemination of resistance genes. The environmental reservoirs of antibiotic resistance, influenced by human activities, are a major concern. Studies have shown that antibiotic resistance genes are widespread in nature, and their presence in the environment can lead to the selection of resistant strains in clinical settings. The genetic mechanisms of resistance, including plasmid-mediated transmission, conjugation, and transformation, are well-studied, but the exact pathways from environmental genes to clinical resistance remain unclear. Integrons, unique gene acquisition elements, have been identified as critical intermediates in the pickup and expression of resistance genes. The ecological roles of antibiotics and antibiotic resistance are also explored, highlighting the need for better control and management of antibiotic use to mitigate the development of resistance.The introduction of antibiotics revolutionized medicine, saving countless lives, but the development of antibiotic resistance has been relentless. The complexity of resistance mechanisms and the lack of basic knowledge have hindered effective prevention and control. Antibiotic resistance is particularly prominent in bacteria, with multidrug-resistant (MDR) strains causing significant morbidity and mortality. The discovery and introduction of antibiotics, such as penicillin and streptomycin, have been followed by the rapid emergence of resistant strains. The genetic and ecological aspects of resistance are crucial, with horizontal gene transfer (HGT) playing a significant role in the dissemination of resistance genes. The environmental reservoirs of antibiotic resistance, influenced by human activities, are a major concern. Studies have shown that antibiotic resistance genes are widespread in nature, and their presence in the environment can lead to the selection of resistant strains in clinical settings. The genetic mechanisms of resistance, including plasmid-mediated transmission, conjugation, and transformation, are well-studied, but the exact pathways from environmental genes to clinical resistance remain unclear. Integrons, unique gene acquisition elements, have been identified as critical intermediates in the pickup and expression of resistance genes. The ecological roles of antibiotics and antibiotic resistance are also explored, highlighting the need for better control and management of antibiotic use to mitigate the development of resistance.