COMLEX Osteopathic Medicine

Category - Asymptomatic

Duncan is a 78-year-old nursing home patient who has discolored mucus coming from his nose. He has no known medication allergies, so you prescribe him Amoxicillin. 3 days later, the symptoms have not improved and Duncan developed a fever of 101 degrees. Which of the following courses of treatment would be most appropriate (barring any other significant medical history or clinical findings)?
  1. Switch antibiotics
  2. Using a nasal swab, take a culture and await results to see what organism could be causing the infection.
  3. Both A and B
  4. Neither A nor B
Answer - C - Nursing home patients are susceptible to infection because of the reduced functionality of their aging immune systems. In community living arrangements such as this, infections with are very common-especially with highly antibiotic resistant bacterial infections, such as MRSA (methicillin resistant S. aureus). The fact that the patient has not responded to Amoxicillin points to a possible diagnosis. The patient should be treated with a different antibiotic. Prior to administration of the antibiotic, a culture should be taken to confirm the diagnosis. Patients who have MRSA should be isolated from other patients to reduce its spread as much as possible.
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