How does finishing the prescription ensure that all the bacteria is killed and that there are no surviving or remaining bacteria? Have always been told that finishing the prescription does this but never how
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Infectious diseases specialist here. This is largely a myth. In almost every occasion researchers have tested in a randomised trial shorter vs longer courses of antibiotics, the shorter course is non inferior (ie no worse than longer) Eg https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736742/
Humans are mostly comprised of bacteria – those living on us and in us outnumber human cells. When you have a bacterial infection there are pathogenic (bad) bacteria which are causing disease (symptoms like cough and fever) which have found and exploited our weakness.
The aim of using antibiotics or antimicrobials is designed to get the blood concentration level of the antibiotic (and then the tissue or site where there is infection) above the inhibitory level of the bacteria where they cannot replicate or where it kills them. You will not kill all the (pathogenic ie bad) bacteria. You are tilting the human vs bad bacteria in favour of the human. The immune system does the rest.
The mention of the need to complete the course is because if you take too short a course or have really poor adherence to the dosing schedule you will not have tilted the fight sufficiently in favour of the human and there will be too many pathogenic bacteria remaining.
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