Antibiotic Use In Respiratory Tract Infections (5)
- 1.
True regarding the treatment of acute rhinosinusitis
- A.
Azithromycin is recommended as an option for first-line treatment
- B.
Doxycycline or a respiratory fluoroquinolone should be instituted in most uncomplicated cases
- C.
Fidaxomicin is now indicated as a primary treatment option
- D.
Antibiotic use is frequently ineffective, given that most cases are viral
Correct Answer
D. Antibiotic use is frequently ineffective, given that most cases are viralExplanation
Watchful waiting is encouraged in uncomplicated cases.
Macrolides (eg, azithromycin, fidaxomicin) are not recommended because resistance in Streptococcus pneumoniae.
First-line therapy is typically amoxicillin or amoxicillin/clavulanate. However, 90%-98% of rhinosinusitis cases are viral, meaning that antibiotics are not effective. Even in cases when the causative agent is bacterial, antibiotics may not be helpful.Rate this question:
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- 2.
Not an indication for antibiotic treatment in patients with acute rhinosinusitis
- A.
Temperature >101.1°F (38.39°C)
- B.
Facial pain lasting 3 days or longer
- C.
Worsening symptoms after an illness lasting 5 days had begun improving
- D.
Persistent symptoms lasting longer than 10 days
Correct Answer
A. Temperature >101.1°F (38.39°C)Explanation
Antibiotic treatment should be reserved for those patients with onset of severe symptoms and those who have persistent symptoms lasting longer than 10 days, who experience double sickening (worsening symptoms after a typical viral illness lasting 5 days had begun improving), who have facial pain or purulent nasal discharge lasting at least 3 consecutive days, or who have a temperature higher than 102.2°F (39°C).Rate this question:
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- 3.
True regarding the treatment of bronchitis?
- A.
Colored sputum indicates bacterial infection necessitating antibiotic treatment
- B.
Longer cough duration suggests a need for antibiotic treatment
- C.
Suspicion of pneumonia is the primary indication to initiate antibiotic treatment
- D.
Routine chest x-ray is indicated in all cases to determine the need for antibiotic treatment
Correct Answer
C. Suspicion of pneumonia is the primary indication to initiate antibiotic treatmentExplanation
Testing and the initiation of antibiotic therapy are not recommended in patients with bronchitis unless pneumonia is suspected. Treatment of symptoms includes cough suppressants, decongestants, beta-agonists, and first-generation antihistamines.Rate this question:
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- 4.
True regarding treatment of the common cold or nonspecific upper respiratory tract infection (URI)
- A.
Antihistamines and nasal saline irrigation are proven treatments for cold symptom relief
- B.
NSAIDs are contraindicated if antibiotic treatment is initiated
- C.
A change in nasal discharge color is an indication for antibiotic initiation
- D.
Educate patients that symptoms may last as long as 2 weeks and do not initiate antibiotics
Correct Answer
D. Educate patients that symptoms may last as long as 2 weeks and do not initiate antibioticsExplanation
Antibiotics are ineffective in treating the common cold.
NSAIDs may be given for symptomatic relief.
Although antihistamines, nasal saline irrigation, opioids, and intranasal steroids have been used, evidence to support their use is lacking.
Change in nasal discharge color is not an indication for antibiotic treatment.Rate this question:
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- 5.
True regarding the treatment of streptococcal pharyngitis
- A.
First-line treatment includes azithromycin and clindamycin
- B.
Initiation of antibiotic treatment prior to the results of a rapid antigen detection test is recommended in symptomatic patients
- C.
Penicillin V remains a first-line therapy due to its reliable antibiotic activity against group A beta-hemolytic streptococcal (GAS) infection
- D.
Severe, persistent sore throat alone is an indication for antibiotic therapy
Correct Answer
C. Penicillin V remains a first-line therapy due to its reliable antibiotic activity against group A beta-hemolytic streptococcal (GAS) infectionExplanation
Do not administer antibiotics until rapid antigen detection test findings confirm diagnosis of GAS infection.
Amoxicillin and penicillin V are first-line treatments thanks to their reliable antibiotic activity against GAS infection.
Resistance to clindamycin and azithromycin has increased.
Antibiotics are usually unnecessary, even in those with sore throats; reassure patients that symptomatic treatment is usually sufficient, and symptoms usually last less than 1 week.
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Jan 23, 2023Quiz Edited by
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Jan 16, 2019Quiz Created by
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