Why should we finish antibiotic treatments in order to prevent antibiotics resistance?
I understand bacteria can mutate and develop resistance against antibiotics, but I do not understand how finishing an antibiotics treatment prevents this.
In my simple thought process, when an individual bacterium has a mutation with antibiotics resistance, the antibiotics do not work on it. So whether I take 1 antibiotics pill or finish the whole treatment would not kill this bacterium, leaving it able to multiply later.
I am guessing the actual situation is either one of these things:
The immune system itself, relieved of pressure by most bacteria being dead, kills the bacteria that developed resistance. Important note here would be that if the immune system is completely shut down, perhaps finishing an antibiotics treatment would actually INCREASE resistance as only the bacteria with resistance would survive. So I suppose this theory is wrong.
Even individual bacteria only developed resistance which is not the same as immunity and bombarding it with antibiotics for multiple days still (usually) means that the bacterium dies.
Does that make sense or is there a thing I'm overlooking here?
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Mayo Clinic on the example of tuberculosis:
Stopping treatment too soon or skipping doses can allow the bacteria
that are still alive to become resistant to those drugs, leading to tuberculosis
that is much more dangerous and difficult to treat.
So, the logic behind completing the course is to kill as much bacteria as possible to prevent the surviving ones to mutate and become resistant.
UPDATE: This question seems to be quite complicated, actually.
According to The BMJ (2017):
However, the idea that stopping antibiotic treatment early encourages
antibiotic resistance is not supported by evidence, while taking
antibiotics for longer than necessary increases the risk of
resistance.
The official policies of prescribing antibiotics have not changed because of such discussions, but the BMJ authors recommend that the information material for the public should contain "take antibiotics exactly as prescribed" and not "finishing the course." So, it's a doctor and not a patient who should decide the treatment period.
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