With regard to addressing infections, no one in this room is saying that antibiotics should not be used. They should be used when appropriate. You start with the right antibiotics and you try to target. The problem becomes complicated in the presence of antimicrobial resistance.
Part of your work then becomes guessing, and that's part of the problem. The other thing is the absence of guidelines that tell you this is an individual who has this kind of infection and this is an appropriate start of antibiotics, versus this individual doesn't need antibiotics because this is a viral infection.
That would address the previous questions on how you explain to the patient and the family why you're avoiding the antibiotic in this case versus using the heavy guns in another case.
It's a combination, and there's no simple answer. I don't know enough details about your particular case. There are ways where guidelines can help us in making sure that patients who need the antibiotics get them immediately, without delay. However, the others who do not are avoiding the antimicrobial use that is unnecessary.
The problem is that there is significant collateral damage. Using broad spectrum antibiotics is not only acting on the patient who is receiving the antibiotic, but it's acting on the hospital environment. These organisms travel between patients and that's why we need to hit them early and hard, but we need to know when to narrow it down.
There are very good case studies of programs that you alluded to in Alberta, and in Mount Sinai. There is expertise, but that is available in patches and does not cover the entire country.