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It would be really bad if antibiotics stopped working
Belief Listing Project: Antibiotics. I'm really happy I live in a time where we have antibiotics. They are an incredibly powerful medical tool, dramatically increasing your chances of surviving hu...
Jeff Kaufman's profile photoBDan Fairchild's profile photoJosh Smift's profile photoEmilyKate McDonough's profile photo
If this fever doesn't break by tomorrow I'll probably need to go to the hospital for a round of IV antibiotics. I've still got my own personal IV pole from the first time. I suspect it's one of the weird symptoms of PKD (same thing Dan Perl has).
Is it possible that, given enough time, antibiotics which are no longer effective could become effective again? If we stopped using them once they weren't effective, it seems like it could happen. Not that I'm banking on this, just musing.
I think one thing that should also be pointed out is that doctors often prescribe antibiotics without confirming if an infection is viral or bacterial. This has happened to me - and I tried to argue with the doctor, but she wouldn't listen. Additionally, sometimes the drugs are prescribed prophylactically - hoping to prevent the onset of a possible bacterial infection (ie. preventing the development of bacterial pneumonia after fighting off a persistent cold, which is viral in nature). I haven't decided yet if I agree with the use of antibiotics prophylactically. I think it might depend on how healthy, or at risk, the patient is for developing the possible bacterial infection. Any thoughts on that?

You point out that patients not being strict with their antibiotic regiments can lead to the spread of resistant bacteria to other people. It's also important to note that that infected individual may ALSO become ill again. Clostridium difficile is a great example of this. Although, part of the reason C. difficile can survive antibiotic treatment is its ability to form spores, which is not an transferrable resistance marker.

+Todd Nelling I think that you raise a good point. If we were to stop using certain antibiotics, it is possible that the genes encoding antibiotic resistance would be lost when the pressure to keep them around was removed. However, the genes for antibiotic resistance have been around since well before we started using antibiotics - they are a natural defense mechanism against bacteria/fungus that secrete the antibacterial toxins. So, they aren't going to disappear completely.

I don't have any concept of how long we would have to stop using a particular antibiotic in order to allow for a drastic reduction of the resistance genes in the bacterial population. Additionally, we've reached a point where bacteria have started to utilize resistance mechanisms that protect them from more than one type of antibiotic - these are mainly pumps that pump the drugs out the bacterial cells before they can function. Therefore, I think we would have to stop use of ALL antibiotics in order to decrease the percentage of resistant bacteria - and that just isn't practical.
+EmilyKate McDonough "I think we would have to stop use of ALL antibiotics in order to decrease the percentage of resistant bacteria"

Wouldn't it be possible to stop using a type of antibiotic, if the issue is that bacteria are adapting to a specific type?

We might be unlucky, however, and find that general antibiotic resistance is also a (very minor) survival advantage for bacteria, helping them against fungi or something. Then bacteria would not lose their antibiotic resistance once they had gained it.
I've been prescribed antibiotics prophylactically, to prevent infection after oral surgery.
+Josh Smift Do you have a congenital heart condition of some sort, or something else that increases your risk from infections? Most people I know who get prophylactic antibiotics for dental work have septal defects or other heart issues that make infections more dangerous.

+EmilyKate McDonough I think that it would take a very long time for resistance genes in the population to be significantly reduced. Unless they had some negative influence on survival out of the presence of the antibiotics, or were associated with something that did, there would be no pressure for them to be eliminated. Look at all the useless stuff that humans are still dragging around.
BDan: Nope; I assumed it was just because the mouth is full of bacteria, and things are more likely to heal cleanly if you're on antibiotics for that first week.
+BDan Fairchild I agree with you if we are talking about resistance markers present in the chromosome, which is true for some resistances (ie. resistance to Rifampacin is due to a mutation in the beta subunit in RNA polymerase). However, if the resistance gene is maintained on a plasmid (extrachromosomal DNA), it will quickly be lost. It takes a lot of energy to maintain a plasmid, and because of that it is disadvantageous to a bacterium to keep it around unless there is pressure to do so. We see this phenomenon quite frequently in lab...

HOWEVER, I do stand by what I said before, that we would have to stop use of all antibiotics... Yes, +Jeff Kaufman , it is true that there are different types of antibiotics - and some resistance genes only provide resistance to certain types or classes of antibiotics. However, there are some resistance genes that work against many types/classes of drugs...mainly pumps.
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