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Aggregate evidence quality: B; randomized controlled trials with limitations.
Benefit Increase clinical cures with narrowest spectrum drug; stepwise increase in broadening spectrum as risk factors for resistance increase. 
Harm Adverse effects of antibiotics including development of hypersensitivity. 
Cost Direct cost of antibiotic therapy. 
Benefits-harm assessment Preponderance of benefit. 
Value judgments Concerns for not encouraging resistance if possible. 
Role of patient preference Potential for shared decision-making that should incorporate the caregiver’s experiences and values. 
Intentional vagueness None. 
Exclusions May include allergy or intolerance. 
Strength Recommendation. 
Aggregate evidence quality: B; randomized controlled trials with limitations.
Benefit Increase clinical cures with narrowest spectrum drug; stepwise increase in broadening spectrum as risk factors for resistance increase. 
Harm Adverse effects of antibiotics including development of hypersensitivity. 
Cost Direct cost of antibiotic therapy. 
Benefits-harm assessment Preponderance of benefit. 
Value judgments Concerns for not encouraging resistance if possible. 
Role of patient preference Potential for shared decision-making that should incorporate the caregiver’s experiences and values. 
Intentional vagueness None. 
Exclusions May include allergy or intolerance. 
Strength Recommendation. 
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