"Bad infections" I really hope you mean bad bacterial infections. If doctors give antibiotics for viral infections (e.g. respiratory infections they fear will become bacterial secondary infections) then we in the rest of the world really need to tell Germany to stop it. Preventive antibiotics is useful for the really vulnerable and chronically ill only.
Here they even stopped for many bacterial infections e.g. typical strep infections and so on, so long as the body takes care of it. I.e. no antibiotics just to shorten the disease period.
My anecdote from the US is that usually my primary care doctor will do a rapid streptococcus test if I come in with a sore throat, and only prescribe antibiotics if it comes back positive. That seems responsible enough for me.
Yeah mine would say "you are in your 40's and healthy so I won't prescribe antibiotics unless it doesn't get better in a week". But that as I said is fairly new and quite specific to sore throat from streps.
The reality on the ground for a doctor is that they don’t always have time to do fancy microscope/lab testing. Skin sore looks infected? Antibiotics. If there’s a 30% likelihood it is a bacterial infection and a .0000000001% chance that the patient develops super-MRSA, the choice is clear.
In my (quite limited) experience the prescription of topical antibiotics like that is not down as much as the oral and injected. Not sure why. Perhaps because because the diagnostics is difficult. Or it's because that kind of antibiotics have lower risk of aiding the development of resistant bacteria. Or there just aren't as many alternatives.
Ah yes a .0000000001% chance that the patient develops super-MRSA, the disease that gets its characteristic deadliness from Multiple Resistances to antibiotics, which bacteria develop when antibiotics are overused. Sounds like a great reason to over prescribe antibiotics.
He's saying that they weigh some chance of increasing antibiotic resistance against the expected value of giving the antibiotic. Depending on your decision theory and utility that may be the right move.
Here they even stopped for many bacterial infections e.g. typical strep infections and so on, so long as the body takes care of it. I.e. no antibiotics just to shorten the disease period.