Antimicrobial resistance, according to the World Health Organization, is the ability of microorganisms to withstand the effects of antibiotics that have been used to treat their infections. Standard treatments are habitually ineffective when microorganisms develop resistance to antibiotics, and in some cases, no medicines provide an effective treatment. Treatments consequently fail. Antibiotics, antivirals, antifungals, and antiparasitic are different forms of antimicrobials that are drugs used to prevent and treat infections in humans, animals, and plants [1]. Worldwide, resistant bacteria and other microbes are also rapidly emerging, jeopardizing the effectiveness of antibiotics, which have revolutionized medicine and prevented millions of deaths [2]. The protection and significance of many emergencies’ medical procedures, such as operations, organ transplants, etc (Success is measured by a drug's capacity to prevent pathogenic bacteria from developing resistance) [3,4]. Any type of microbe can become resistant to medication. Antibiotic, antifungal, antiviral, and parasite resistance are consequences [5].

Antimicrobial resistance was primarily responsible for 1.27 million fatalities globally in 2019.One in five children under five died from antimicrobial resistance, and antimicrobial resistance may have been a major consideration in five million deaths [6] Antimicrobial resistance thus has pessimistic implications for both the health and economic sectors in both developed and developing countries [7]. A condition in which the body becomes more susceptible to disease and then treatment becomes challenging as pathogens develop immunity to the frequently taken antimicrobial drugs often results from the resistance developing naturally over time, typically through genetic changes derived from subpar infection control practices, neglected use of antimicrobials, and persistent rejection of warnings about overuse of medications [8] and self-medication as a result of the expensive healthcare system [9], which relates to clinical negligence on the part of medical staff. Other attributes encompass intensive agricultural use, epidemics, disinfectants, healthcare systems because of excessive antimicrobial use during those times, environmental pollution, improper disposal of unused or expired medications, and a lack of knowledge, initiatives, and awareness regarding best practices that can result in excessive or inappropriate use [10].

Regrettably, the negligent use of these medications is ending their miraculous effects. Due to the increased number of hospitalizations around the world, often in Sudan, the rapid development of resistance is to blame for thousands of deaths and economic difficulties [11]. The majority of medications, including antibiotics and antimalarials, can be purchased at neighborhood pharmacies in Sudan without a prescription, though there are laws that classify medications as either prescription-only or appropriate for over-the-counter sale [12]. The seriousness of the problem is demonstrated by the numerous studies conducted in Sudan that have encountered elevated incidences of the emergence of resistant strains in a variety of pathogens.

Evidence showed that 3rd generation cephalosporin resistance was present in 90% to 100% of Enterobacteriaceae isolates in Ibn Sine Hospital during the Sudanese years 2008 to 2010, 78% and 80% of E. coli and K pneumonia, respectively, were ESBL producers, 51% of Staph aureus was MRSA, and the prevalence of vancomycin-resistant enterococcus ranged from 21% in Soba Hospital to 33% at the National Health Laboratory [11].