A 45-year-old man is evaluated because of the acute onset of right ear pain. The patient was well until 10 days ago, when he developed symptoms of an URTI, including nasal congestion and a nonproductive cough. Although these symptoms are resolving, pain and some loss of hearing in the right ear first occurred last night. He does not have fever, sore throat, or drainage from the ear. PMH is unremarkable. The patient has no allergies and takes no medications. On examination, vitals, including temperature, are normal. The right tympanic membrane is erythematous, opacified, and immobile, but the external canal is normal. The left ear and posterior pharynx are normal. Examination of the chest is unremarkable. Which of the following is the best initial antibiotic choice in this patient?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Amoxicillin-clavulanate.
This is acute otitis media (erythematous, opacified, immobile TM after a URTI, normal canal). In the cohort's antibiotics lecture the empiric choice for acute otitis media (and sinusitis) is oral amoxicillin-clavulanate, which covers S. pneumoniae plus beta-lactamase producers (H. influenzae, M. catarrhalis). Plain amoxicillin is first-line in some external guidelines, but the course material lists amox-clav; azithromycin and ceftriaxone are not the listed first choices.
ليش كل خيار صح أو غلط
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A
ليش غلط
Plain amoxicillin is an extended-spectrum penicillin without a beta-lactamase inhibitor. Adding the inhibitor (amoxicillin-clavulanate) gives cover of gram-negatives such as H. influenzae and M. catarrhalis, and amoxicillin-clavulanate is the lecture's empiric choice for otitis media.
✓ Antibiotic-1 (3).pdf · p. 11 -
B
ليش صح
Acute otitis media (red, opacified, immobile eardrum after a URTI) is treated empirically with oral amoxicillin-clavulanate (the organism is S. pneumoniae).
✓ Inefctious Diseases 🦠.pdf · p. 6 -
C
ليش غلط
Azithromycin is a macrolide, listed as an alternative in penicillin allergy. This patient has no allergies, so it is not the first choice.
✓ Antibiotics.pdf · p. 3 -
D
ليش غلط
Ceftriaxone is a third-generation cephalosporin, listed for CAP, gonorrhea, community meningitis and intra-abdominal infection, not as the first choice for otitis media.
✓ Antibiotic-1 (3).pdf · p. 15
- المصدر
- Antibiotic-1 (3).pdf · p. 35
Antibiotics 🍓.pdf · p. 1 - المحاضرة
- Antimicrobials · Infectious Diseases · Module B
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