I’m assuming it has to do with making sure you get any straggler bacteria, but wouldn’t taking all the pills at once shock and awe the little buggers and force them to surrender?
In: Biology
Always follow the instructions, don’t get medical advice from the Internet.
If you take too much antibiotic, you can poison yourself.
If you stop taking it after killing many, but not all, of the bacteria you help the bacteria evolve to be antibiotic resistant; which endangers all of humanity.
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On a basic level, your body just doesn’t work that way.
* You can’t eat 7 days worth of food all at once and then just not eat for 7 days.
* You can’t sleep for 56 hours once a week.
* You can’t take a week’s worth of medicine all at once.
Lots of processes in the body take time to work, and if you try to “front load” or “shock your system” like that whatever it can’t use right away is wasted.
There’s two ways (ish) that antibiotics work. One is by actually killing bacteria, one is by preventing them from multiplying. If you take the kind that prevents multiplying it would be like putting them on birth control for a day and then they’d go back to making babies.
So let’s say you’re taking the kind that kills bacteria. The first problem is that higher dosages don’t necessarily translate to higher levels of medication in your blood, at a certain point your body just doesn’t absorb more.
Assuming that you could infinitely increase the dosage until the point that it immediately wiped out all susceptible bacteria: the problem is that you have wiped out all susceptible bacteria: which includes bacteria that you need to be healthy
Basically, the idea with antibiotics is just to slow the bacteria down enough that your immune system can kill them, on the assumption that your immune system knows which bacteria are harmful (which of course isn’t always the case)
There are different ways an antibiotic can work. Most don’t actually kill the bacteria up front like you would expect. Many work by inturupting natural processes in different ways to cause the bacteria to die. It’s been a while since I studied this, so I’m sure I’ll be corrected if I say something wrong. One of the main ways is during the growth phase. Bacteria have a tough to penetrate outer layer which prevents bad stuff for them from getting inside. When they are growing, they need to kind of break thier own cell wall, and put more of it in between. The new material fuses with the old stuff and you have a solid barrier again. The antibiotic can fuse to the tough stuff once it breaks, and prevents it from sticking back to itself. This means they no longer have a solid wall around them, and bad things can get in as well as the inside stuff leaking out. When that happens, the bacteria dies.
If the bacteria isn’t in the growing phase, the antibiotics can’t get in to disrupt the wall from sticking back together and does nothing. This is one reason why you take it over a few days, to make sure it will be in your system during that growth phase. Another reason is that when the inside stuff leaks out, it can be pretty nasty for your body to handle. We can deal with little bits of it over time, but if all the bacteria were to explode at once, it’ll poison you and you would die.
Edit: fixed some typos.
Because it doesn’t work like that.
That really is the ELI5 of it
You can’t drink a week’s worth of water in one go and then not drink anything for another week. You can’t sleep a week’s worth of sleep in one go and then stay awake for another week.
Your body doesn’t work that way.
The dosing of antibiotics has been honed over decades, both the number of pills you take per day and how many days you take them for.
Follow the instructions. Take the correct number of pills in each dose. Complete the whole number of pills/days, even if you start to feel better.
I research antibiotic resistance for a living. There’s a couple reasons main you can’t do this (and bunch of other small ones).
1. Antibiotics do come with a level of toxicity. You can’t just take all the antibiotics at once because it could easily be poisonous in that quantity. Same reason you can drink 1 beer an hour for 12 hours and be (relatively) okay, but if you drink 12 beers in 1 hour you’d be in bad shape.
2. Antibiotics can’t always get to bacteria. Differences in where the bacteria are influences how hard it hits them. Sometimes the bad bacteria can be in little pockets where the antibiotic doesn’t reach. In that case, you could do this fast “shock” treatment and wipe out most bacteria, but you’d increase the odds of just missing the target entirely.
3. It takes some time for the antibiotic to actually get through your body, and bacteria have responses to keep them alive during quick dangerous events. A long constant dose of antibiotic means there will be more drug around them for longer, so they can’t use the quick panic button responses. Imagine like a pufferfish–it can puff up to escape danger, but it can’t stay puffed up forever.
4. Antibiotics don’t always kill bacteria. Many antibiotics just stop bacteria from growing, but don’t actually kill. Your body’s immune system is what actually kills the bacteria, and the antibiotics give them an edge to stop the bacteria from reproducing faster than the body can get rid of them. In that case, a big dose all at once is going to be much much less useful, since the bacteria will just keep growing once that big dose is gone.
People are looking into ways to use this method you’re thinking about for treatment, but it’s for very specific scenarios and very much early stages of research.
And there are of course a lot more intricacies to this and other factors, but this is an oversimplified explanation of some of the big ones.
The scheduling of antibiotics is critical to their effectiveness. You need to maintain the concentration at effective levels for an effective length of time. It’s not like using a hammer on a bug where you are done in one whack. all at once.
“Instead of drinking several glasses of water every day to stay hydrated, why can’t I just pound 5 gallons one night a week and be set?”
“Instead of trying to get 2-3 grams of dietary potassium intake a day, why can’t I eat a 1kg brick of alkali metal once a year?”
“Brawndo, the Thirst Mutilator has what plants crave!”
These are not meant to imply this is a dumb question, but to illustrate that the basic idea “living things need [X] to be healthy” can be correct but, applied aggressively without understanding the details of the underlying balance, leads to bad outcomes.
Toxicity is in the dosage. Too much of practically anything at once can kill you or seriously mess you up. Your body is a balance of lots of different interconnecting systems and subsytems that all have certain needs and certain rhythms. If you push a system too far out of balance, even by flooding it with something that is good/necessary in smaller doses, it may not recover.
In the case of antibiotics, there’s probably not much risk of a lethal “overdose” because they naturally pass through your system pretty quickly… much like a tank column smashing their way through lightly defended territory. You would probably devastate your gut bacteria and have horrible diarrhea for days, and there are cases of antibiotic overuse where the gut never really recovers its balance and you just have the shits forever.
Also, antibiotics can work by disrupting the way bacteria multiply. If you take a dose, you’ll affect the bacteria multiplying during that dose, but others are just chilling. By spreading the dose, you’re targeting them all during their multiplying phase.
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