[mdphd] Paper on empiric antibiotic therapy

[Adam Wegman]

Hello all--

Re./  today's GR case, I've attached a classic paper that puts empiric
antibiotic therapy in context. I've found the authors' schema of
therapeutic options useful (observation, prophylaxis, empiric therapy,
therapeutic trial, specific therapy), along with their insightful list of
"fallacies of antibiotic therapy".

They also criticize using terms like "big gun" or "heavy hitter" to
describe antibiotics:

"ideas regarding the relative strengths and weaknesses of antibiotics are
> not confined to their spectrum, mode of pharmacologic activity, or specific
> toxicity (such as salt load) but extend to an abstract sense of “power.”


Mark Crislip <https://sciencebasedmedicine.org/a-medical-skeptical-classic/>
has a memorable summary of what they mean by this:

If I had neurosyphilis, and there are those who suspect I do, the ‘strong’
> or ‘powerful’ ciprofloxicin would do nothing to treat my infection, but
> ancient, weak old penicillin remains the treatment of choice.


Enjoy!


Adam
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Name: Kim, Gallis - 1989 - Observations on spiraling empiricism its causes, allure, and perils, with particular reference to antibiotic therap.pdf
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