# Antibiotic resistance **URL:** \ **Category:** Factual Questions\ **Created:** [August 3, 2019, 1:34pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110 "2019-08-03T13:34:06Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![SuntanLotion](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/suntanlotion/32/16165_2.png) [@SuntanLotion](https://boards.straightdope.com/u/SuntanLotion)\ **Post date:** [August 3, 2019, 1:34pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/1 "2019-08-03T13:34:06Z")
Is it possible to become tolerant of antibiotics? I’ve taken them a lot when younger. I used to get upper respiratory infections every winter and was always given penicillin or amoxicillin. Last February (2018) I had to take three separate runs of antibiotics during the month (don’t ask). The last one, after one day I felt bright eyed and bushy tailed and was eating everything in sight. Well, I was sick recently(bad cough, fever) and was given some amoxicillin (875 mg twice a day) and its been three days, and though I feel better, I’m not 100% better and my appetite isn’t back yet. What happens if one becomes resistant to antibiotics? ---
**Author:** ![Kimera757](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kimera757/32/3765_2.png) [@Kimera757](https://boards.straightdope.com/u/Kimera757)\ **Post date:** [August 3, 2019, 1:45pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/2 "2019-08-03T13:45:11Z")
That is discussed in this paper: [The anti-penicillin antibodies levels in sensitive and insensitive people to intradermal skin test - PubMed](https://www.ncbi.nlm.nih.gov/pubmed/30223394) However, it seems reactions to penicillin (the one I chose) are typically allergic reactions. I think in your case the bacteria are simply resistant to penicillin. Of course, I’m not a doctor! Because someone will ask, I understand that Amoxicillin is a variant of penicillin. ---
**Author:** ![Francis\_Vaughan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/francis_vaughan/32/3093_2.png) [@Francis\_Vaughan](https://boards.straightdope.com/u/Francis_Vaughan)\ **Post date:** [August 3, 2019, 2:30pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/3 "2019-08-03T14:30:09Z")
You don’t become resistant to antibiotics - not in the sense of developing a tolerance. Antibiotics are not drugs that are intended to do anything to you at all, their job is to act on bacteria, slowing them down enough that your body has enough time to mount its own defence and your immune system wipes them out. This is a quite different mode of operation to most medical drugs, that are intended to have some action on your body’s own biochemistry. Resistance to antibiotics occurs when the bacteria evolve to get around the action the antibiotic has on their biochemistry. Some develop enzymes that degrade the antibiotic, some develop additional chemical pathways so they survive when the pathway targeted by the antibiotic is degraded, and so on. That isn’t a tolerance either. Drug tolerances tend to be when a drug is modifying or acting alongside some regulated chemistry in your body, and the presence of the drug over time causes the body’s internal regulation to compensate for the drug’s effect, making the drug less effective. Since antibiotics don’t (or at least are not intended to) act on you at all, this doesn’t happen. If an antibiotic is less effective than last time it almost certainly means you have a different breed of bacteria to contend with. ---
**Author:** ![Riemann](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/riemann/32/3133_2.png) [@Riemann](https://boards.straightdope.com/u/Riemann)\ **Post date:** [August 3, 2019, 4:10pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/4 "2019-08-03T16:10:10Z")
> [@Francis\_Vaughan](#): > > Resistance to antibiotics occurs when the bacteria evolve to get around the action the antibiotic has on their biochemistry. Some develop enzymes that degrade the antibiotic, some develop additional chemical pathways so they survive when the pathway targeted by the antibiotic is degraded, and so on. And to add - the reason that this is such a problem with bacteria is because they are very small, and they multiply very fast. If you have a bacterial infection, there may be billions of bacteria present. You take an antibiotic that kills them. But suppose just _one_ of those bacteria has a chance mutation that makes it resistant to that antibiotic. With all its buddies gone, that single surviving bug finds itself all alone with plenty of nutrients available and room to grow. Suppose its replication cycle is 1 hour. In just 30 hours of doubling every hour you are back to a billion bacteria, all of which are descendants of that one resistant bug. ---
**Author:** ![Blue\_Blistering\_Barnacle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blue_blistering_barnacle/32/3386_2.png) [@Blue\_Blistering\_Barnacle](https://boards.straightdope.com/u/Blue_Blistering_Barnacle)\ **Post date:** [August 3, 2019, 10:24pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/5 "2019-08-03T22:24:58Z")
> [@Riemann](#): > > And to add - the reason that this is such a problem with bacteria is because they are very small, and they multiply very fast. If you have a bacterial infection, there may be billions of bacteria present. You take an antibiotic that kills them. But suppose just _one_ of those bacteria has a chance mutation that makes it resistant to that antibiotic. With all its buddies gone, that single surviving bug finds itself all alone with plenty of nutrients available and room to grow. Suppose its replication cycle is 1 hour. In just 30 hours of doubling every hour you are back to a billion bacteria, all of which are descendants of that one resistant bug. Now I have to add, it’s not quite as bad as that. In most cases (that is, common bacteria and immunocompetent patients), antibiotics mostly just tilt the playing field against bacteria, giving time for the patient to “gain the upper hand”. (Mostly) complete eradication of bacteria with antibiotics alone is not required or even possible. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [August 4, 2019, 1:32am UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/6 "2019-08-04T01:32:53Z")
Also, over 99% of respiratory infections are viral, and all the antibiotics do is help raise the chances of getting a resistant strain of bacteria bred. The medical community is working quite hard to stop the prescribing of antibiotics for viral infections. This includes classic cold symptoms, sore throats, sinus infections, and ear infections too. Also bronchitis, which is almost always viral unless one has COPD, in which case it’s usually viral. ---
**Author:** ![Riemann](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/riemann/32/3133_2.png) [@Riemann](https://boards.straightdope.com/u/Riemann)\ **Post date:** [August 4, 2019, 2:25am UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/7 "2019-08-04T02:25:42Z")
> [@Blue\_Blistering\_Barnacle](#): > > Now I have to add, it’s not quite as bad as that… Yes, of course. If it were quite that bad, we’d all be dead. But bacteria do evolve extremely fast because of their short generation time. And we’re exposing them to strong _artificial_ selection by overusing antibiotics. Wolves have a generation time 4 or 5 orders of magnitude longer, and it took us a few thousand years to turn majestic wolves into pseudo-rats. With artificial selection we can bring about equally dramatic changes to bacterial populations in weeks or months. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [August 4, 2019, 2:36am UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/8 "2019-08-04T02:36:27Z")
Even if the infection is being overcome by the antibiotic and your immune system, you may simply have been so ill in the first place that your body needs extra time to fully recover. ---
**Author:** ![ftg](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ftg/32/2801_2.png) [@ftg](https://boards.straightdope.com/u/ftg)\ **Post date:** [August 4, 2019, 1:49pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/9 "2019-08-04T13:49:30Z")
> [@Qadgop\_the\_Mercotan](#): > > Also, over 99% of respiratory infections are viral, and all the antibiotics do is help raise the chances of getting a resistant strain of bacteria bred. The medical community is working quite hard to stop the prescribing of antibiotics for viral infections. This includes classic cold symptoms, sore throats, sinus infections, and ear infections too. Also bronchitis, which is almost always viral unless one has COPD, in which case it’s usually viral. This doesn’t make sense. E.g., from [here](https://en.wikipedia.org/wiki/Pneumonia#Cause): “In adults, viruses account for approximately a third and in children for about 15% of pneumonia cases.” Even with bronchitis the number is closer to 90% viral. ---
**Author:** ![Blue\_Blistering\_Barnacle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blue_blistering_barnacle/32/3386_2.png) [@Blue\_Blistering\_Barnacle](https://boards.straightdope.com/u/Blue_Blistering_Barnacle)\ **Post date:** [August 4, 2019, 2:18pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/10 "2019-08-04T14:18:52Z")
> [@Qadgop\_the\_Mercotan](#): > > Also, over 99% of respiratory infections are viral, and all the antibiotics do is help raise the chances of getting a resistant strain of bacteria bred. The medical community is working quite hard to stop the prescribing of antibiotics for viral infections. This includes classic cold symptoms, sore throats, sinus infections, and ear infections too. Also bronchitis, which is almost always viral unless one has COPD, in which case it’s usually viral. > [@ftg](#): > > This doesn’t make sense. E.g., from [here](https://en.wikipedia.org/wiki/Pneumonia#Cause): > > “In adults, viruses account for approximately a third and in children for about 15% of pneumonia cases.” > > Even with bronchitis the number is closer to 90% viral. Well, most respiratory infections are “upper respiratory infections”, usually common cold; “lower respiratory infection”, which includes pneumonia and bronchitis, is much less common. Bacterial infections get a lot more press, because they are often more serious and are treatable with antibiotics. So a few bacteria get written and thought about a lot, compared to a whole zoo of viruses, which are mostly handled with supportive care. BTW, bacterial mutation and evolution is downright sluggish compared to viruses. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [August 6, 2019, 3:16am UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/11 "2019-08-06T03:16:02Z")
> [@ftg](#): > > This doesn’t make sense. E.g., from [here](https://en.wikipedia.org/wiki/Pneumonia#Cause): > > “In adults, viruses account for approximately a third and in children for about 15% of pneumonia cases.” > > Even with bronchitis the number is closer to 90% viral. I never mentioned pneumonia, which is what your link is talking about. Pneumonia is complicated and more often bacterial, though viruses and chemicals and allergens also cause it. And over 90% of the reported/studied cases of bronchitis are viral. ONCE you add in the COPD cases. Exclude those, as I did in my post, and the number is more like 99%. Also: I’m not impressed with wikipedia’s cited sources nor its summary of them. ---
**Author:** ![ftg](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ftg/32/2801_2.png) [@ftg](https://boards.straightdope.com/u/ftg)\ **Post date:** [August 6, 2019, 12:34pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/12 "2019-08-06T12:34:47Z")
**Qadgop** , you said “over 99% of respiratory infections”. Pneumonia _is_ a respiratory infection. I don’t get the quibbling at all. At least I gave cites. ---
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [August 6, 2019, 12:37pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/13 "2019-08-06T12:37:50Z")
> [@ftg](#): > > **Qadgop** , you said “over 99% of respiratory infections”. Pneumonia _is_ a respiratory infection. > > I don’t get the quibbling at all. > > At least I gave cites. Okay, 90-99%. :rolleyes: ---
**Author:** ![SuntanLotion](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/suntanlotion/32/16165_2.png) [@SuntanLotion](https://boards.straightdope.com/u/SuntanLotion)\ **Post date:** [August 6, 2019, 1:12pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/14 "2019-08-06T13:12:27Z")
Well, I went back to the dr and told her I felt totally weak and no appetite and she let me see her colleague, so she said maybe I need an extra boost so she prescribed me a different antibiotic and prednisone. When I got home, I realized I was starting to feel better so am deciding not to take these other scrips. Never heard of prednisone. ---
**Author:** ![Telemark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/telemark/32/372_2.png) [@Telemark](https://boards.straightdope.com/u/Telemark)\ **Post date:** [August 6, 2019, 1:24pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/15 "2019-08-06T13:24:44Z")
Prednisone is a very commonly prescribed corticosteroid. I’ve used it multiple times for allergy related breathing problems. > **[Prednisone Uses, Dosage, Side Effects, Warnings - Drugs.com](https://www.drugs.com/prednisone.html)** > > Prednisone is used to treat allergic disorders, ulcerative colitis, psoriasis and arthritis. Learn about side effects, interactions and indications. ---
**Author:** ![SuntanLotion](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/suntanlotion/32/16165_2.png) [@SuntanLotion](https://boards.straightdope.com/u/SuntanLotion)\ **Post date:** [August 6, 2019, 1:32pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/16 "2019-08-06T13:32:13Z")
I don’t see how they thought that would help me. ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [August 6, 2019, 1:39pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/17 "2019-08-06T13:39:19Z")
> [@SuntanLotion](#): > > I don’t see how they thought that would help me. It reduces inflammation, among other effects. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [August 6, 2019, 2:06pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/18 "2019-08-06T14:06:15Z")
Yes, pneumonia is (usually) a respiratory infection. But the vast majority of respiratory infections are not pneumonia. I wouldn’t be surprised if the various rhinoviruses (common cold), by themselves, already accounted for over 99% of respiratory infections, even before accounting for non-cold viruses. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [August 6, 2019, 7:32pm UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/19 "2019-08-06T19:32:06Z")
> [@ftg](#): > > **Qadgop** , you said “over 99% of respiratory infections”. Pneumonia _is_ a respiratory infection. > > I don’t get the quibbling at all. > > At least I gave cites. OK, I sure could have been clearer, but have been posting on the road on inferior devices, and in my daughter’s hospital room where she’s once again in with a respiratory infection (bacterial, including some super scary ones like MRSA, pseudomonas, and Burkholderia). Believe me, I know of what I speak (wish I didn’t), even if I’m rather more dysgraphic and discombobulated in recent days/weeks. No snark at you was intended on my part, I just made a passing shot at wikipedia, then discovered I lacked resources at the time to cite my fave source, UpToDate on the topic, and failed to edit my comments. Respiratory infection includes upper respiratory infection too, i.e. the common cold, which is what bumps the percentage to \>99% overall for viral cause of respiratory infection. Of lower respiratory infections, bronchitis is somewhat greater than 90% viral, tho if you have severe COPD in that situation it’s about 70% viral. Pneumonia is nowhere near as common as bronchitis, tho it’s hardly rare. The exact breakdown, percentage-wise of causes of pneumonia varies widely both among populations, regions, and times of year. But a ton of viruses cause pneumonia too, including: Influenza A and B viruses •Rhinoviruses •Parainfluenza viruses •Adenoviruses •Respiratory syncytial virus •Human metapneumovirus •Coronaviruses (eg, Middle East respiratory syndrome coronavirus) •Human bocaviruses However, even more bacteria can cause it. Anyway, apologies for giving the topic short shrift, and I’ll try to avoid doing ‘hit and run/miss’ posting until things settle down. ---
**Author:** ![ThisSpaceForRent](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thisspaceforrent/32/345_2.png) [@ThisSpaceForRent](https://boards.straightdope.com/u/ThisSpaceForRent)\ **Post date:** [August 7, 2019, 1:08am UTC](https://boards.straightdope.com/t/antibiotic-resistance/838110/20 "2019-08-07T01:08:19Z")
> [@Qadgop\_the\_Mercotan](#): > > Also, over 99% of respiratory infections are viral, and all the antibiotics do is help raise the chances of getting a resistant strain of bacteria bred. The medical community is working quite hard to stop the prescribing of antibiotics for viral infections. This includes classic cold symptoms, sore throats, sinus infections, and ear infections too. Also bronchitis, which is almost always viral unless one has COPD, in which case it’s usually viral. Thumbs Up. I am not a doctor, but I have known this for years. Antibiotics are not anti-viral. [Next page](https://boards.straightdope.com/t/antibiotic-resistance/838110.md?page=2)