– Why can’t you take all of the pills in an antibiotic prescription in one day, rather than 2 or 3 per day

Question

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

Answer 1

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.