Skip a pill - Antibiotics

One of the most ancient traditions in microbiology consists in arriving to the lab, opening the stove, look at the petri dishes you left there the day before and curse. Curse a lot. Curse those colorful stains and thin hairs that warn you that the dish was contaminated and that, besides of the things you left there to grow, there's a whole zoo of microscopic critters having lunch on the experiment that took you days to do. The thing is, when you're a genius, things can be different: September 28th, 1928 (one day after my birthday! The egocentric reference is always a good memory aid); Alexander Fleming woke up and changed history (some speculate that before doing so he had breakfast, unlike me).

Registries display, that besides being a genius and blah blah blah, Fleming was a lousy lab technician. So lousy that one day, after a trip to Scotland that included lots of false promises from pleated skirts, he found dishes of Staphylococcus aureus absolutely contaminated with a fungus. And the bacteria? Oh, they were OK, thanks for asking.

Nah, bullshit. Far from OK: They were absolutely dead.

Finding a culture totally destroyed is really bad news, unless you notice that you've found a compound able to save millions of lives from that moment on, and decide to isolate it, instead of cursing and trashing the dishes. That blueish minichampignon was the Penicillium notatum, and the magic compound, penicillin. Bacterial slayer and "the one to rule them all".

It was so important to discover this first antibiotic that research in this field literally exploded, shaking other microorganisms until other compounds were found, one after another, able to attack the most diverse pathogens, each single one of them with a particular mechanism. Hitmen, efficient mercenaries that changed a deadly disease into a minor "take 2 amoxicillin pills and you'll be fine".

Yet, the fact that we oversleep from time to time does not mean that nature does the same.

When a bacteria proliferates in an organism, it does it with minor variations as the generations progress. Under the same rules that made that a single cell evolved into a dog, a cat, and Peter; the guy from the grocery store.

Whenever you look at a biologic process you've to look at it under the evolutive point of view. From the enormous offspring that first bacteria had, some, by chance mutated and were born resistant to the antibiotic.

Houston, we've a problem.

The doctor insists that you take your antibiotics until the end of the treatment period, but you feel great, and since we are all immortal until the contrary is proven, you are back into walking barefooted, naked... and leave the last few pills untouched. Anyways, what's the worst that could happen?

What antibiotics do is help you out a bit. Kill a large amount of the bacterial population, so that your body may handle the minor leftovers and survivors that may have developed a resistance to the Antibiotic during the infection. Now, if you take that backup force out -by leaving the remaining pills-, your body has to fight alone, splitting the defenses in the antibiotic resistant bacteria and also the non-resistant. An infection is gone when NOTHING is left. Just as a person cannot be "a bit" pregnant, neither can you be "a bit" free of infection. Now the daughters of the daughters of daughters... (this goes on...) of the first colonizers that originally infected you are worse, stronger and meaner than their predecessors, because they are immune to the antibiotic.

Out of nowhere electricity is gone, clothes become formal. you're back in the 18th century and your body don't know anything related to Fleming, because whatever you throw at it, it has to fight it off alone. Because you did not the those 3 pills you had left (and you already paid for!); "why does it matter? you can always buy generic stuff at the store!" Sometimes you nail the treatment, it's true (lucky self-medication). Until... it does "not nail it". Until stronger infections show up, because you're mixing ABs and giving them a resistance to all of them. You've created a monster.

Peter is warning about the wolf. Peter takes amoxicillin a few days before, because his throat itches, just in case, take a few and "it's solved". Millions of Peters are offering Bacteria a chance to face natural selection, and naturally, they leave a healthy and antibiotic resistant offspring as they do. And someone wont be strong and healthy then: Peter.


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