<b>Low-income countries become the dominant hotspot for river antibiotics risks</b>

Environmental exposure to antibiotic pollutions can have negative effects on the health of ecosystems and humans, while quantifying the global scale of this risk remains challenging in rivers. Here, we construct a high-resolution spatiotemporal dataset estimating global river antibiotics risk from 2000 to 2019. Antibiotics risk showed an average annual growth rate of +1.19% yr^-1. In low-income countries, relatively modest investments on wastewater treatment and optimizations livestock density management can yield more substantial reductions in antibiotic risks. These findings provide direction to regions struggling with water quality around the world, highlighting narrow the gaps between antibiotics contamination risk and income levels.