A new strain of tuberculosis (TB) bacteria has emerged that is resistant to several antibiotics. Explain how this resistant strain developed and why completing a full course of antibiotics is important in preventing the spread of resistant strains.

Pearson Edexcel A-Level Biology A (9BI0) — 5.4 Antibiotics and resistance · Explain · 5 marks · View as Markdown

Written & reviewed by James Millett — Biology (Imperial College London), PGCE Science (University of Cambridge).

Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis. Treatment requires patients to take a combination of antibiotics for at least six months. In some countries, patients stop taking their antibiotics once they feel better, after only a few weeks.

Model answer (5 marks)

Some bacteria in the original population have a random mutation that gives resistance to an antibiotic.
The antibiotic kills the susceptible bacteria, leaving the resistant ones alive.
The surviving resistant bacteria reproduce and pass the resistance gene to their offspring.
If a patient stops the antibiotic course early, some non‑resistant bacteria may survive and could mutate, or the remaining resistant bacteria are not fully eliminated.
Completing the full course ensures all bacteria are killed, reducing the chance of resistant strains developing and spreading to others.

Examiner tips

  • Use the exact terms ‘mutation’, ‘resistant’, ‘susceptible’, ‘reproduce’, ‘allele’, ‘full course’
  • Show the cause–effect chain: mutation → selection → reproduction → spread
  • Keep the answer to 5 points, one per mark

Common mistakes

  • Mixing up ‘mutation’ with ‘acquisition’ of resistance
  • Forgetting to mention that the antibiotic kills susceptible bacteria
  • Not linking early stopping to the survival of resistant bacteria

Mark scheme (5 marks)

  1. Some bacteria in the original population have a random mutation that gives resistance to an antibiotic
  2. Antibiotic kills non-resistant bacteria / susceptible bacteria are killed, leaving resistant bacteria to survive
  3. Resistant bacteria reproduce and pass on the resistance gene / allele to offspring
  4. If a patient stops the antibiotic course early, some non-resistant bacteria may survive and could mutate / resistant bacteria are not fully eliminated
  5. Completing the full course ensures all bacteria are killed, reducing the chance of resistant strains developing and spreading to others

Key terms in this question

antibiotic · resistant strain

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