My understanding is that the antibiotics won’t kill the random mutant bacteria anyway, so doesn’t killing off all the susceptible ones just allow for more room for the mutants?
Does it have to do with more base bacteria getting the chance to mutate? A specific resistance has to be pretty rare right? Or will you have multiples of the same mutation in a “colony”?
In: Biology
For your antibiotic a population of bacteria will have varying degrees of resistance. When you start taking the antibiotics the ones with susceptibility to the antibiotic will die first and the more resistant ones will last longer. The full course of antibiotics is designed to last long enough that, when combined with your immune system, all of the bad bacteria will be dead.
If you stop before the full course is done then you may have a small amount of the most resistant bacteria left. Maybe your immune system manages to clear them up in a few days but in that time you pass them to someone else. Now they have bacteria that is extra strong. If you repeat this resistance increasing process a bunch of times you end up with bacteria that are the best of the best of the best at resisting antibiotics and that’s a problem.
There are solutions for the super bugs but if we could not have them in the first place that would be better.
Just like in any population of people, some bugs are tougher than others
If you don’t finish the course of antibiotics, you may leave a few bugs behind , albeit in a weakened state.
Those bugs recover and are effectively immunized against the antibiotic and then they start to multiply again and their offspring are immune to the medication
Just because you feel better doesn’t mean all of the bacteria is gone. You could still have some half-killed bacteria in your system. If that isn’t fully killed, you risk allowing it to mutate and become resistant. If it does that and replicates itself, you’ve just created a antibiotic resistant bacteria.
ALWAYS finish the course even if you feel better.
There exists resistance in the group. Antibiotic kills the bugs without resistance, leaves behind bugs that can survive the antibiotic. Leaves more resources for those bugs that then multiply. The few resistant bugs become the majority.
Edit: I think I misunderstood. So you aren’t normally aiming for killing all the bugs, but enough that your immune system can do the job. So if you take an appropriate course of antibiotics, there are low enough quantities for your immune system to handle. If you take less, you may have killed some of the susceptible bugs, but not enough. So then you have a mix of resistant and susceptible bugs that survived that can overwhelm your immune system. For certain types of resistance, the factors that lead to it can be traded among the colony. Now you have overwhelming infection with large quantities of resistant organisms
I do the entire course of treatment and so should everyone but…..
I’ve looked for evidence that there is a scientific basis for a “course” of treatment but it is just folk wisdom.
That isn’t to say that there isn’t merit to it but what I’m saying is that the length of treatment is entirely arbitrary.
Someone at the beginning of antibiotics said a week should do it and now it’s set in stone.
No double blind experiments. Nothing.
No tests or evaluations for different antibiotics against different gram negative bacteria. Nothing.
Most stuff in medicine is a WAG but their WAG is probably ok.
As an engineer sometimes I think there is very little diff between med and voodoo that’s why I try and avoid at all possible.
And I have a few friends who are in that trade.
It’s exactly like they say, “What doesn’t kill you makes you stronger.” Almost but not quite killing the bacteria concentrates the stronger survivors, and then they have more resistant progeny. It pushes their evolution toward superbugs.
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