Re: Do unneeded antibiotic treatments help evolve resistant bacteria?

On 31 Mag, 19:30, "Alan Meyer" <amey...@xxxxxxxxx> wrote:
I recently met a rather unimpressive doctor who told me that he
prescribes antibiotics for any of his patients who ask for them.
He said he knows that in many cases the drugs will do no good,
but they do no harm and if the patient wants them, he aims to
please.

There are a lot of problems with this stance given that
antibiotics can indeed have negative side effects for the
patients. But I'm particularly interested in understanding
whether this practice contributes to the evolution of antibiotic
resistant bacteria.

The doctor insisted it did not. He said that, if the people
don't have bacterial infections, they can't develop resistant
bacteria.

People always have bacteria in their bodies. Usually these bacterial
populations don't cause any problem, but sometimes they can go out of
control (they reproduce too much or they spread to body parts where
they are not supposed to be) then antibiotics are needed to resolve
the situation. If those bacteria have evolved a resistance to a
particular antibiotic class, then those antibiotics fill fail.

Also I think (but I'm not sure about this) that bacteria can excange
genetic mateial, thus a normal occourring bacterium could in principle
transfer his antibiotic resistance to a pathogen bacterium.

And if they do have infections, they still won't
develop resistant bacteria unless they fail to take the full
course of therapy, typically anywhere from 10-28 days.

There is no guarantee that the therapy kills all the targeted
bacteria. Even if a single resitant individual survives, it can
rebuild the population.

Every time you show the enemy your weapons tactics, you run the risk
that the next time they will be prepared to counter them. Therefore
it's better not to do that unless the benefit is greater than the
risk.

Another much more reputable doctor was present during this
conversation. He told me that he would not prescribe antibiotics
unless there was evidence of a bacterial infection, no matter
what the patient wanted. However he thought the first doctor was
right about the evolution of AB resistant bacteria.

Does anyone have any information about this? Do you think the
doctors are right or wrong about the development of antibiotic
resistant bacteria?

Thanks.

Alan



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