Hi Jodey,
I used pulse antibiotics with my last sugar cat. However, I need to state that Luigi had a condition called EGC Eosinophilic Granuloma Complex. He would have regular skin, mouth and paw pad inflammation and was susceptible to skin infections. We used pulse and therapy on and off for a few years.
Generally I would know if he had something brewing from inflated high numbers that didn't move at all. Sometimes we would do a culture to choose the abx, and other times, the Vet would select one based on previous trials and how the abx worked in the past.
Bloodwork is important with this method though, so that's something to consider.