how does not finishing a course of antibiotics cause antibiotic resistance?
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This notion is actually being challenged I think, but the thinking was that in an infection you would have millions and millions of bacteria. It’s likely that within this population, some bacteria will be less likely to be killed as quickly. Carrying on the course would still stress them an eventually work or enable your immune system to clear the infection. If you stop, these few bacteria that are less susceptible grow and replace the original population, or go on to spread elsewhere. Repeat this cycle and incrementally you get more and more resistant bacteria.
Punching somebody doesn’t always kill someone on the first punch. A series of punches has a better chance. Punching someone over and over everyday for a couple of weeks will likely pulverize someone’s face and kill them. If you punch them one time, they can recover from it. Punch them one more time a few days later, they’ll start to learn how to bob and weave. Eventually the punched person will learn how to counterpunch and beat up the person hitting them.
Bacteria have wildly varying genes. A small number of bacteria are naturally resistant to anti biotics. Most resistant bacteria are still hurt by anti biotics, but need a longer exposure to get destroyed.
Without anti biotics, there is no reason for the resistant bacteria to have an advantage. Do they only make up a small number of the bacteria infecting you.
If you take anti biotics long enough to kill the nonresistant bacteria, but not long enough to completely kill the resistant bacteria, you’ll give the resistant bacteria an advantage. So once the nonresistant bacteria are gone and you stop taking the anti biotics, the resistant ones can start multiplying again and cause an infection primarily caused by resistant bacteria.
They’re like the Russian military… Give them the chance for a ceasefire and they will do their best to multiply and reinvade Ukraine…
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You are breeding better bacteria.
The weak die in the first couple of days. The strong live. You stop taking antibiotics earlier than prescribed, you allow the strong to breed and repopulate. But this time with the strong resistant ones, not the weak ones that died. Some of the strong ones can develop to be super strong, meaning resistant.
Not a perfect comparison, but you’re five so:
Not finishing an antibiotic course is like giving your illness a vaccine for the antibiotic. When we get a flu vaccine, it’s a weak version of the flu that teaches our body how to fight it.
When you give bacteria *some* antibiotics, the surviving bacteria have now learned how to fight that antibiotic. Completing the full course ensures that all those little bacteria are dead, though, so there is nobody left to learn and reproduce.
BE AWARE – THE ANSWERS HERE ARE INCORRECT AND FOLLOW THE OLD WAY OF THINKING: The new guidelines no longer recommend to take antibiotics for completion. You may discontinue your antibiotics 24h after resolution of your symptoms.
This helps for many reasons
1) you better retain the natural diversity of bacteria instead of eliminating them all, this prevents takeover of a superbug like C. Diff
2) if some of the bacteria have antibiotics resistance, taking the medication longer will ensure only the bug with the strongest resistance will continue to survive and accelerate formation of resistance.
Professionals are realizing we have relied too heavily on antibiotics and are now urging stewardship of their use if we want to keep them as a tool in our arsenal. We have our own immune systems that should be put to use. Antibiotics can aid them but they shouldn’t do the whole job for us.
Think of it like this: your body is infected with letters A-Z.
You take some antibiotics and after a few days, it kills all of the consonants, but the vowels AEIOU are still hanging on.
You feel mostly better, so you stop.
AEIOU now take all the free space and nutrients and multiply.
You take your antibiotics again. But it’s AEIOU town and they don’t go down so easily.
Chiming in here: When, every couple of years, I manage to get a cystitis, they usually gave me a one dose medication. A little sachet with a powdered antibiotic. So far, this has worked just fine, but after reading this, I have no idea how one dose kills all those evil little bastards down there. Has anyone an ELI2,5 for me?
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