• Euzebiusz Jamrozik and George S Heriot.
• The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford. Old Road Campus, Oxford OX3 7LF, UK.
• Br. Med. Bull. 2022 Mar 21; 141 (1): 4144-14.

Introduction Or BackgroundAntibiotic resistance raises ethical issues due to the severe and inequitably distributed consequences caused by individual actions and policies.Sources Of DataSynthesis of ethical, scientific and clinical literature.Areas Of AgreementEthical analyses have focused on the moral responsibilities of patients to complete antibiotic courses, resistance as a tragedy of the commons and attempts to limit use through antibiotic stewardship.Areas Of ControversyEach of these analyses has significant limitations and can result in self-defeating or overly narrow implications for policy.Growing PointsMore complex analyses focus on ethical implications of ubiquitous asymptomatic carriage of resistant bacteria, non-linear outcomes within and between patients over time and global variation in resistant disease burdens.Areas Timely For Developing ResearchNeglected topics include the harms of antibiotic use, including off-target effects on the human microbiome, and the lack of evidence guiding most antibiotic prescription decisions.© The Author(s) 2021. Published by Oxford University Press.

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