Re: Do unneeded antibiotic treatments help evolve resistant bacteria?
- From: Vend <vend82@xxxxxxxxxxx>
- Date: Wed, 6 Jun 2007 14:47:29 -0400 (EDT)
On 4 Giu, 06:30, Lorentz <drosen0...@xxxxxxxxx> wrote:
Does anyone have any information about this? Do you think the
doctors are right or wrong about the development of antibiotic
resistant bacteria?
I don't have hard citations on this. However, you asked for an
opinion so I'll give one that I hope sounds educated based on general
principles of evolution.
I think that they are a little bit wrong when they say that
antibiotic resistance can't develope if the course of teatment is
followed to the very end. However, their course of treatment may be
the best of possible evils. Allow me to expand.
I think that they are assumming that their course of treatment
will kill each and every relevant bacterium in the body. A general
principle in evolution is that evolution rarely or never occurs in
sudden jumps. Therefore, an intense treatment by antibiotics can in
principle kill each and every bacterium in the body. There is no way a
bacterial variety can arise if each and every bacterium in the body is
annihilated. The bacterial population doesn't have enough variability
in it to assure that some bacterium will be resistant enough to
survive an intense and prolonged treatment. If bacteria do survive,
over generations they could accumulate enough variation to resist
almost any level of antibiotics. However, an intense course of
treatment won't allow that.
The doctors may be partially correct. Their treatment may be so
intense that the invading species of bacterium under consideration is
completely exterminated, without a single survivor. The chance that
that species of bacterium will give rise to an antibiotic bacterium
would then be very small, if the treatment is intense enough.
Therefore, a really aggressive offense against the little buggers may
not be too bad.
The doctors are may be wrong in terms of public health for the
following reasons.
The doctors have no way of being sure that their regime is brutal
enough to kill each and every of the invading species. The regime
keeps on until in their experience, the disease has no chance of
coming back. But that doesn't mean that all the bacteria of that
species are dead. But I think that it probably is a fair guess that
they are.
Not necessarily.
There are lots of different antibiotics.
In my understanding, antibiotics belong to classes, that is, many
antibiotics are variations of relatively few types of molecules.
A specific antibiotic of a certain class may be very effective against
certain species of bacteria and only slightly effective against other
species. Thus even an intensive treatment if not correctly targeted
could be not effective enough to kill all the bacterial population but
effective enough to cause it to evolve a resistance.
Sometimes the resistance will be against the whole class of
antibiotics, which might include those that were really effective
agaist that species of bacteria.
It's a mechanism similar, in some aspects, to the mechanism of
vaccination:
You give the subject low-grade/inactivated/broken pathogens and the
immune system develops a resistance to the wild full functional
pathogen.
I used to refuse antibiotics when I thought that I had a
viral infection. What happened several times is that I got pneumonia,
from a secondary bacterial infection. Viral infections in the lungs
are VERY often followed by secondary bacterial infections. The
bacterial infections appear to have weakened my lungs to the point
that I get new pneumonia infections almost every year. This is a
documented phenomenon, lungs don't always recover from bacterial
infections. I am so afraid of bacterial infections that I want no
chance of getting them. I rationalize that when I get bacterial
infections, I end up using antibiotics anyway which probably makes
more AR varieties of bacteria. When I do take antibiotics, I insist on
an intense treatment. However, the effects on my digestion are
extremely bad. I am tempted to stop taking the antibiotics, which I
refuse to do. I prefer to nuke the buggers. I know that I may be
helping to produce superbug. But make no mistake, my social
consciousness ends where my lungs begin.
So maybe I am a hypocrite.
Maybe you should try to avoid viral infection in the first place.
It's not just a matter of social consciousness: if you evolve
resistant pathogen in your body, it's likely that you will be the
first one to pay the consequences.
.
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