A new commentary published in the medical literature draws a critical distinction between appropriate antibiotic prophylaxis and defensive ‘just in case’ prescribing—a distinction that may hold the key to slowing the global antimicrobial resistance crisis. Prophylactic antibiotics serve a legitimate clinical purpose in high-risk populations, including surgical patients, immunocompromised individuals, and those with conditions like rheumatic heart disease. However, healthcare providers increasingly prescribe antibiotics without clear clinical justification, driven by defensive medicine rather than evidence-based protocols. This shift represents a subtle but consequential departure from sound clinical decision-making. Experts warn that healthcare systems must establish clear stewardship frameworks to differentiate between justified prophylaxis and unnecessary prescribing, ensuring that antibiotic efficacy is preserved for future generations of patients.
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