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.
