Re: Do unneeded antibiotic treatments help evolve resistant bacteria?

Alan Meyer 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. 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.

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
Guy and Vend have already commented that the doctors are wrong, and given
the explanation. I only wanted to note that as I recall the experiment has
already been done, in the Netherlands. One of the few antibiotics still
effective against some multi-resistant bacteria (most likely staph) was
being added to animal feed. Resistance to the antibiotic was rapidly
spreading among hospital strains of the bacteria. The government banned the
use of the antibiotic in animal feed, and resistance among the hospital
strains rapidly diminished. Now perhaps this is an aprocryphal story, as I
can't remember where I read about it. But it is certainly consistent with
what we know about the spread of resistance to antibiotics in general among
bacteria, and it is exactly counter to what your doctors thought.

--
Yours, Bill Morse

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