Biology as Poetry: Micro Pharmacology

Bacteriophage Ecology Group

Presumptive Treatment

Initiation of a medical procedure prior to completion of diagnosis.

Presumptive treatments are therefore based on what essentially are educated guesses, where specific signs and symptoms typically are associated with specific causes and therefore may be susceptible to specific treatments. The problem with presumptive treatments are not that they are done at all – which in many cases can be convenient and economical as well as reduce the duration of suffering – but instead to the extent that treatment side effects may be unnecessarily endured as a consequence of misdiagnosis and thereby inappropriate treatment.

For bacterial infections, presumptive treatment often begins prior to bacterial culturing, for example, as well as prior to confirmation of bacterial antibiotic sensitivity. While side effects associated with antibiotic use certainly exist, the problems associated with presumptive treatment using antibiotics can be more insidious. In particular, antibiotics can affect normal flora, leading to superinfection as well as potentially longer-term changes in health. In addition, unnecessary antibiotic use can lead to the evolution of antibiotic resistance.

Note that presumptive treatment can be dependent on the use of drugs which are useful under a variety of circumstances, which for antibacterial drugs often can mean broad spectrum of activity. Since the more insidious downsides of antibiotic use can be tied to antibiotics affecting other than target organisms, presumptive treatment may be indirectly tied to problems associated with antibiotic usage such that its common use in medical practice can serve to inhibit the development of antibacterials that possess narrower spectra of activity.

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