There will always be new targets for new antibiotics. That's not the problem. The problem is that we started, with Penicillin, by picking off the low-hanging fruit. Now the bacteria are playing an impressive game of catch-up. Soon, the speed with which they will be able to develop new resistances will overtake the speed at which we can develop new antibiotics. (Also, more potent antibiotics are more likely to have nasty side-effects.)
The good news is that the Russians have already done a great deal of work toward the post-antibiotic era by working on bacteriophage therapies. Bacteriophages are the long-term end-game to keeping bacteria in check, since they can be made to evolve at the same or faster speeds than bacteria.
What is needed now is more research into bacteriophages, and much, much more research into Evolutionary Dynamics, so that we have some clue what is going on (and so that we can better predict the future development of resistances).
Of course, it's kinda hard to do research into Evolutionary Dynamics when the richest country in the world has political leaders that still question the validity of evolution...
Sure, the human body can develop antibodies against literally anything, living or not. But antibody production is not instantaneous and can have a lag time of 7 to 10 days, which should be sufficient time for the phages to do their work. Also, since phages do not enter human cells, you won't get the typical response from APC's or Helper T-Cells, which will lead to even more sluggish antibody response.
Bottom line: none of the research done on phage therapy has indicated that this is a blocker.
So far, the main blockers to the development of phage therapy are: the FDA doesn't know how to approve them, companies don't know how to patent them, and people freak out when a doctor says: "Now I'm going to give you a virus..."
My hypothesis is that immunizations can be dramatically improved. Bacteria use a variety of secreted toxins, quorum sensing factors, biofilm scaffolds, and so forth. It would be very good if we could immunize against the few thousand most common virulence factors. Those pathways also provide ripe targets for conventional drugs.
"But antibody production is not instantaneous and can have a lag time of 7 to 10 days, which should be sufficient time for the phages to do their work."
Once, which don't get me wrong is very nice for the patient. But cutting the rate of fatal childhood infections 50% from the natural rate is not good enough. We want 99.99%.
"Also, since phages do not enter human cells, you won't get the typical response from APC's or Helper T-Cells, ..."
They do when their bacterial hosts are endocytosed.
Immunizations are, ultimately, subject to the same problems of evolved avoidance as antibiotics.
The current approach to treating diseases reminds me of the story of how the Yugoslav army shot down an F-117. They had spotters telling them when the F-117 got close, they operated radar that could almost, sorta see them, and they relied on a proximity fuse, a generous damage radius, and a helluva lot of luck. We may currently be able to determine roughly what an infection is, and how it's likely to behave, but we're far, far from being able to determine any of this with sufficient accuracy.
What's really needed is a combination approach, but even a combination approach is useless until we understand more about how bacteria evolve...
Immunity against bacterial virulence factors tends to be persistent. The nature of the proteins is that they cannot change much without losing function. (Unlike viral surface coats.)
The good news is that the Russians have already done a great deal of work toward the post-antibiotic era by working on bacteriophage therapies. Bacteriophages are the long-term end-game to keeping bacteria in check, since they can be made to evolve at the same or faster speeds than bacteria.
What is needed now is more research into bacteriophages, and much, much more research into Evolutionary Dynamics, so that we have some clue what is going on (and so that we can better predict the future development of resistances).
Of course, it's kinda hard to do research into Evolutionary Dynamics when the richest country in the world has political leaders that still question the validity of evolution...