We like to use the narrowest spectrum antibiotics possible to limit side effects and breeding resistance. Also, the really broad spectrum ones are expensive.
I've been in clinical rotations and my attending physicians have been very clear about antibiotic use and there is a lot of clinical evidence and guidance for minimizing broad spectrum use.
Everyone knows you get a culture for an animal bite and then write a prescription for the single species of bacteria infecting the wound. It's just procedure! Same for tick bites, definitely not just writing out amoxicillin and calling it a day, gotta wait two weeks and send in some blood work first to give the Lyme disease time to settle in and show up nice and clean.
Empiric treatment is not the broadest spectrum possible. Yes, they will put someone on Augmentin for a human bite, but that's very different from putting someone on IV vancomycin or meropenem. The augmentin will probably cover anything in that bite, but if the culture comes back showing resistance, then you switch to something else.
Correct. I'm a third year medical student on my clinical rotations right now, and I worked in the medical field for 4 years before starting med school.