Spiraling empiricism just refers to the fact that it has gotten much easier to prescribe an antibiotic than it is to do a careful diagnostic evaluation and figure out what's going on in the patient that you are For instance, the approach that we used to take was careful observation while doing appropriate diagnostic tests and then choosing antibiotic therapy, either giving it as a therapeutic trial or specific therapy. What we are seeing more and more of today is that people are using antibiotics more and more for prophylaxis, or empirically without having a diagnosis and what we are Now, the way physicians use antibiotics is unfortunately based a lot of fallacies that people hold about antibiotics. What I call this is lies your parents told you about antibiotics. The first fallacy, or the first lie, is that antibiotics are cheap and easy. However, they aren't cheap.
Antibiotics are the second most commonly used class of drugs in the United States.
All of the cardiovascular agents are There are other newer mechanisms that I don't have on there that are starting to become elucidated. For instance, certain organisms now are actually producing efflux pumps, so that when an antibiotic does gain access to a bacteria, they spit it out. So there are a lot of new mechanisms that are actually coming into being. This is just a slide that shows where the various antibiotics act. Regardless of where the antibiotics act, whether it is at the cell wall, the DNA level, like the quinolones, the RNA level, like tetracycline and aminoglycosides, or in folate metabolism, like co-trimoxazole or Bactrim, there can be mutations at every step and you can have resistance emerging at any step of the activity.