Comment on Open Thread: May 2010, Part 2

Sat, 22 May 2010 14:50:29 GMT

Do you have a citation for that?

As far as I understand it, when giving antibiotics to a specific patient, doctors often follow your advice - they give them in overwhelming force to eradicate the bacteria completely. For example, they'll often give several different antibiotics so that bacteria that develop resistance to one are killed off by the others before they can spread. Side effects and cost limit how many antibiotics you give to one patient, but in principle people aren't deliberately scrimping on the antibiotics in an individual context.

The "give as few antibiotics as possible" rule mostly applies to giving them to as few patients as possible. If there's a patient who seems likely to get better on their own without drugs, then giving the patient antibiotics just gives the bacteria a chance to become resistant to antibiotics, and then you start getting a bunch of patients infected with multiple-drug-resistant bacteria.

The idea of eradicating entire species of bacteria is mostly a pipe dream. Unlike strains of virus that have been successfully eradicated, like smallpox, most pathogenic bacteria have huge bio-reservoirs in water or air or soil or animals or on the skin of healthy humans. So the best we can hope to do is eradicate them in individual patients.

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