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penicilling t1_itv51ji wrote

First of all, people do not become resistant to antibiotics. Bacteria become resistant to antibiotics.

Basically, exposure to antibiotics can cause bacteria to evolve, as the bacteria that are not resistant are killed, and those that are survive. (Some bacteria have a way to share genes through a DNA structure called a plasmid, and antibiotic resistance can be passed along that way as well).

So the skin and the gastrointestinal tract are covered / filled with bacteria. If your bacterial microbiome has resistant bacteria in it, and you develop an infection from one of these bacteria, then the standard antibiotics might not work.

What does the doctor do?

Often, when treating a bacterial infection, the physician will obtain a test called a "culture and sensitivity". They take infected material (such as urine, pus, or sputum) and try to grow the bacteria that is causing the infection. After the lab grows it, then it can be identified through a series of tests (gram stain, for example). Once the bacteria is grown and identified, then they check sensitivities to antibiotics.

Sensitivity checking involves growing the bacteria again under new circumstances. Basically, a series of small paper discs impregnated with various antibiotics are placed on the Agar plate where they are growing the bacteria. By measuring the distance at which the bacteria can grown close to each disc, they can tell if the bacterium is likely to be sensitive or resistant to a particular antibiotic. Then the physician selects an appropriate antibiotic.

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champdecap OP t1_itv6j4j wrote

I was wondering about this, but one must emphasise that there are only a few varieties of antibiotics (I'm just thinking names) available and what if none worked? Someone in comments said that doctors take samples of antibodies built in our system and I guess make some sort of injectable antibiotic specially designed for your body which I wonder will be costly as hell. And I assume it takes time to develop such things what will that person do till there is a cure?

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TiredNurse111 t1_itxp14v wrote

If they can’t fight it off with supportive care and it goes systemic? They will probably die. Luckily this isn’t common.

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aTacoParty t1_iu1v92d wrote

There are actually quite a few types of antibiotics. Most people don't hear about most of them because they're reserved for specific infections (oral vancomycin for c difficile, isoniazid/rifampin for tuberculosis, linezolid for MRSA, and carbapenems as a last resort). Most common bacterial infections are treated with common antibiotics to limit bacterial resistance.

If a bacterial infection is resistant to treatment, additional antibiotics will be added in combination. Investigational antibiotics may also be used if the benefit outweighs the risk. Currently there are studies being performed to try and identify antibiotic (or other drug) combinations that more effectively kill bacteria. Some drugs work together synergistically (IE they're better together than expected) while others antagonistically (IE they work against each other) and it's not clear why.

Treatment options for multi-drug resistant bacteria - www.frontiersin.org/articles/10.3389/fmicb.2019.00080

Assessment of drug interactions - https://www.science.org/doi/10.1126/sciadv.1701881

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