What are the mechanisms of antibiotic resistance? Bacteria can achieve antibiotic resistance through four fundamental mechanisms. Inactivation physically destroys the antibiotics before they can do their job. Alteration of the binding site leaves the antibiotic without a binding site, and therefore unable to work. Alteration of a metabolic pathway completely bypasses the activity of the antibiotic. Finally, reduction of accumulation keeps the intracellular levels of antibiotics low.

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