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Medical Forum / General / General / February 2008question about antibiotics
Is it true that if an antibiotic is not taken regularly it stops being effective for that person, even at a distance of months or years? i.e. if the doctor prescribes you an antibiotic and you forget to take it several times, then that medication will never work as well for you again? > Is it true that if an antibiotic is not taken regularly it stops being > effective for that person, even at a distance of months or years? i.e. > if the doctor prescribes you an antibiotic and you forget to take it > several times, then that medication will never work as well for you > again? The problem is that if you don't take your full course, the bacteria are more likely to become resistant to the bacteria. If the resistant bacteria are not causing the next infection, the antibiotic will work as well as before. If the resistant bacteria are causing the infection, then antibiotics might not be as effective. One unfortunate thing is that bacteria which become antibiotic to one antibiotic may be resistant to unrelated antibiotics. How effective the antibiotic will be depends on how long ago the infection was, what antibiotic it was, where the new infection is, and whether or not the bacteria became resistant to your antibiotic. Jeff Hi Jeff, thanks for the information. What do you mean by "not taking the full course"? Do you mean, for example, if someone is prescribed an antibiotic for 2 weeks but only takes it for a couple of days? Or someone who does take it for three weeks but forgets it a few times? > Hi Jeff, thanks for the information. What do you mean by "not taking > the full course"? Do you mean, for example, if someone is prescribed > an antibiotic for 2 weeks but only takes it for a couple of days? Or > someone who does take it for three weeks but forgets it a few times? I would think that both the amount of medication taken, and how quickly it is taken, would affect how likely it is for bacteria to develop resistance. This is because both time and regularity of dose affect the level of antibiotic in the body - if you take only a couple of days of medication, you'd get a high level for a short time - killing off the non-resistant bacteria, but allowing any resistant bacteria to survive and become the dominant type. If you take the dose over a longer course of time, any bacteria with resistance genes would have a selective advantage in the environment of a low dose of antibiotic. Therefore, take the dose prescribed and follow the dosage instructions. The genes for resistance are often stored in a separate bit of DNA from the bacteria's genome. They cost energy to replicate, so bacteria that have resistance genes will grow slower than those without. They cost energy to use making resistant bacteria less efficient compared to non-resistant. Throw an antibiotic into the mix, and those resistant bacteria now have an advantage that offsets the cost of carrying those genes, and so they have a chance to become the dominant type. They can also share genes with other types of bacteria, which is how we have strains that are resistant to multiple antibiotics at the same time. Hit them with a high enough dose right at the start, and you may well kill them all off, in spite of the resistance genes. Another factor is how quickly your body clears a drug. Your liver recognises certain compounds for removal and deactivation, and many of our drugs fall into this category. In the same way that a caffeine addict needs to drink more coffee to get the same hit as time goes by, so our bodies become more efficient at clearing drugs from our system the more we take of them. Patients with chronic pain need increasingly higher doses of morphine, and some go up to doses that would kill someone never exposed to the drug before. A similar mechanism operates with antibiotics, but exactly how much this would contribute to an antibiotic not being effective I don't have any specific data. Andrew Porter > Hi Jeff, thanks for the information. What do you mean by "not taking > the full course"? Do you mean, for example, if someone is prescribed > an antibiotic for 2 weeks but only takes it for a couple of days? Or > someone who does take it for three weeks but forgets it a few times? Not taking it for the full two weeks (e.g., taking it for only two days). Forgetting a few times won't have as much effect as taking it only two days. Jeff The best way is to take it for a couple of days , then the body takes over and finishes off the bugs Is it true that if an antibiotic is not taken regularly it stops being effective for that person, even at a distance of months or years? i.e. if the doctor prescribes you an antibiotic and you forget to take it several times, then that medication will never work as well for you again? > The best way is to take it for a couple of days , then the > body takes over and finishes off the bugs The best way is to follow the doctor's instructions, not some guy you don't know on the internet. Jeff > Is it true that if an antibiotic is not taken regularly it stops being > effective for that person, even at a distance of months or years? i.e. > if the doctor prescribes you an antibiotic and you forget to take it > several times, then that medication will never work as well for you > again? > The best way is to take it for a couple of days , then the > body takes over and finishes off the bugs Um, did you miss my post? Exposing bacteria to small amounts of antibiotic creates exactly the right environment for creating resistant strains. Follow the doctor's/pharmacists instructions. Incidentally, antibiotics have to work with the body's immune system to be effective; those on immune-suppressive treatments or with depleted immunity as a result of diseases such as AIDS are very vulnerable to infection, and to serious illness and even death as a result, even when treated with antibiotics. So your body plays a key role in clearing infection, and works in synergy with the drugs. So if you're into holistic medicine etc, then you don't need to feel bad about taking antibiotics, your body is still very important in fighting disease. Those who tell you to finish the course of antibiotics are saying it without any evidence base . Ask any doctor . None of them take antibiotics for more than two days at a time , and inspite of being exposed to so many bugs all day they remain healthy. If they finished the course , they would kill off a lot of good bugs and fall ill all the time. > Those who tell you to finish the course of antibiotics are > saying it without any evidence base . What is your evidence base? > Ask any doctor . None of them take antibiotics for more than > two days at a time , and inspite of being exposed to so many bugs all > day they remain healthy. Really? I am a doctor and always finish my course of antibiotics. > If they finished the course , they would kill off a lot of > good bugs and fall ill all the time. What is your evidence base for this? Jeff |
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