A principle of infectious diseases is “antimicrobial stewardship” which involves choosing the right antibiotic for the right patient and never over-prescribing or blanket covering patients who don’t need treatment. Another principle is “narrowing the spectrum” of a drug once the organism is identified by culture or other methods.
These fundamental approaches to the use of antibiotics work to limit the problem of bacterial resistance and the development of “superbugs.” Every year hospitals each produce their antibiogram or report of their common infections encountered and what antibiotics either are effective (organism is sensitive) or ineffective (organism is resistant). In the SARS-CoV-2 pandemic these principles have been applied to the use of monoclonal antibodies and the process explains why various EUA products (e.g., bamlanivimab) were pulled from the market when they were understood to be no longer effective at neutralizing SARS-CoV-2.
