1. Introduction
  1.1 Background and significance
  1.2 Objectives of the study
2. Biochemical Mechanisms of Antibiotic Resistance
  2.1 Drug efflux and multidrug resistance pumps
  2.2 Target modification and antibiotic binding sites
  2.3 Enzymatic inactivation and antibiotic degradation
3. Genetic and Biochemical Factors in Resistance
  3.1 Acquisition and spread of resistance genes
  3.2 Horizontal gene transfer and plasmids
  3.3 Mutations and selection pressure
4. Biochemical Adaptations in Resistant Bacteria
  4.1 Metabolic changes and altered pathways
  4.2 Biofilm formation and antibiotic tolerance
  4.3 Quorum sensing and communication in resistance
5. Strategies to Overcome Antibiotic Resistance
  5.1 Combination therapy and synergistic effects
  5.2 Targeting resistance mechanisms and pathways
  5.3 Development of new antibiotics and alternatives