When Antibiotics Don’t Work, that can be a frightening experience for many since people often rely on antibiotics to eliminate their infections, and if an infection isn’t gone after taking the full course of antibiotics, it can mean you might need another trip to the doctor, a different antibiotic, and some people who are very ill may even need to be hospitalized. In any case, it means your symptoms haven’t gone away and that can be scary. We trust that the antibiotics we take will work to eliminate our infection, but sometimes antibiotics don’t work, so lets explain why.
Antibiotics Only Work if You Have a Bacterial Infection
One of the most common reasons that antibiotics don’t work is because you don’t have a bacterial infection. When people are sick and go to the doctor, they expect to get some kind of prescription. After all, that’s what doctors are for, right? But what many people don’t understand is that antibiotics only work to kill bacteria, and infections can be caused by:
- Even parasites
But antibiotics only kill bacteria. Colds, the flu, vomiting and diarrhea, even many sinus infections or prostate infections are just not caused by bacteria, so an antibiotic will be completely worthless. In fact, Antibiotics Are Prescribed Inappropriately As Much As 50% of the Time because doctors will often give out antibiotics for things such as colds, many times because the patient expects to get antibiotics when they are sick!
But you can’t take antibiotics for a virus or a parasite. While giving antibiotics when someone doesn’t have a bacterial infection may not seem like a big problem, it is not only a big problem for the patient, but for the world. This leads us to the next reason why sometimes antibiotics don’t work.
Antibiotics Don’t Work Because of Antibiotic Resistance
When antibiotics are given appropriately for a bacterial infection, but they still don’t work, sometimes it’s due to a problem called antibiotic resistance. When antibiotics first began Widespread Use in the 1940’s , they were such a game-changer in medicine as to almost be miraculous. Suddenly, people began to be cured of infections they would have certainly died from without them.
But antibiotics don’t kill every single bacteria in any infection, some of them survive to go on and grow. Those that do survive often were able to survive because they were able to withstand the killing power of the antibiotic better than the others. When they reproduce, they pass this trait onto the next generation. When the same antibiotic is used many times on the same bacteria, these colonies develop traits to withstand the killing, and antibiotics don’t work on them any longer. When this happens, we call it antibiotic resistance, and it’s a worldwide problem because many of the bacteria that cause infections are becoming resistant to all antibiotics.
This condition, called multiple drug resistance, is already here for some organisms, such as Methicillin Resistant Staph Aureus, also known as MRSA, for which doctors have limited options to treat the infection. That some antibiotics are resistant to certain drugs leads us to our next section.
The Doctor Chose the Wrong Antibiotic
Sometimes when antibiotics don’t work, it’s because the doctor chose the wrong antibiotic. One of the reasons we go to a doctor is that they have training in which antibiotics to choose for which infections. There have been tens of thousands of studies done on which anti-infectives to use for which infections, and doctors must understand all of the options. It goes beyond just giving an anti-viral for a viral infection, an anti-fungal for a fungal infection, and an antibiotic for a bacterial infection, it also means choosing between the many different antibiotics for the one that will kill that specific bacterial infection the best.
While there are lots of studies on this, it’s not an exact science, and doctors can sometimes get it wrong, sometimes simply because they made a mistake and prescribed an antibiotic that shouldn’t have been prescribed, and sometimes because that antibiotic should have worked, but the bacteria became resistant to the antibiotic. This is one of the reasons why it’s best for doctors to take a sample of the infection, and test it to make sure that:
- The infection is the bacteria they think it is
- The bacteria is sensitive to the antibiotic given to kill it
This test is called a Culture and Sensitivity Test and is done routinely millions of times a day in hospitals and doctors offices around the world. While this is ideal to do in order to find out the exact organism causing the infection, and the best drug to kill it, this is not always done because:
- It is expensive
- It takes 3 to 5 days to get results
- It isn’t always practical to get a culture depending upon where the infection is located
For instance, getting a sample of an infected cyst on the liver requires a surgical procedure and the person may be so sick they don’t have time to wait 3-5 days to get the results. So, they do the next best thing and simply use what has worked for thousands of doctors in the past. As we can see, that doesn’t always translate into the correct antibiotic, and sometimes the antibiotics don’t work, for a variety of different reasons.