[chris_va]

Agreed, but the level of research in novel antibiotics is really quite limited, mostly due to a lack of return on investment.

This actually means there is almost certainly a lot of unexplored potential, but getting drug makers interested is quite difficult (though in the last 5 years the field has been 10x more popular).

Most antibiotics on the market are just penicillin variants (well, β-lactam variants), mostly because that was one of the first things to blow onto a petri dish, was non-toxic, easy to manufacture, small molecular weight, and it happened to work quite broadly. Most bacteria share β-lactamase encoding plasmids with each other, so resistance is conferred within years (I think the original penicillin made it 4 years). Honestly we have done very little outside of this space.

β-lactamase inhibitors (basically blocking the method of resistance with a separate drug) have a lot of potential, as do many other combination therapy techniques. There are also many other non-β-lactam templates we could play around with.

With modern sequencing, you can actually identify the exact resistance mechanism of each strain you encounter. If we move to rapid diagnostic sequencing, we can tailor the treatment to avoid any existing resistance for the specific infection.