Aggregate evidence quality: B; randomized controlled trials with limitations.
BenefitIncrease clinical cures with narrowest spectrum drug; stepwise increase in broadening spectrum as risk factors for resistance increase.
HarmAdverse effects of antibiotics including development of hypersensitivity.
CostDirect cost of antibiotic therapy.
Benefits-harm assessmentPreponderance of benefit.
Value judgmentsConcerns for not encouraging resistance if possible.
Role of patient preferencePotential for shared decision-making that should incorporate the caregiver’s experiences and values.
Intentional vaguenessNone.
ExclusionsMay include allergy or intolerance.
StrengthRecommendation.