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Review Question - QID 100002

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QID 100002 (Type "100002" in App Search)
A 26-year-old patient presents to your office with rhinorrhea that you believe to be viral in origin. He respectfully requests treatment with antibiotics, and he demonstrates an understanding of the risks, benefits, and alternatives to treatment. His mental status is intact, and you believe him to have full decision-making capacity. Which of the following is the best course of action?

Prescribe ciprofloxacin

4%

3/69

Prescribe amoxicillin

13%

9/69

Prescribe zidovudine

4%

3/69

Refer the patient to an infectious disease specialist

20%

14/69

Deny the patient's request

48%

33/69

Select Answer to see Preferred Response

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Antibiotics should not be prescribed for infections of viral origin. Adverse effects of antibiotics pose real risks to the patient, and inappropriate use of antibiotics contributes to antibiotic resistance.

According to Wang et al., "In patients with sore throat, a diagnosis of group A beta-hemolytic streptococcus pharyngitis generally requires confirmation with rapid antigen testing, although other guidelines allow for empiric therapy if a validated clinical rule suggests a high likelihood of infection. Acute bronchitis in otherwise healthy adults should not be treated with antibiotics; delayed prescriptions may help ease patient fears and simultaneously reduce inappropriate use of antibiotics."

Incorrect answers:
Answers 1 and 2: Ciprofloxacin is a 2nd generation fluoroquinolone antibiotic. Amoxicillin is an aminopenicillin antibiotic. Although the principle of patient autonomy states that patient's preferences in medical care should be honored, this principle does not permit the patient to demand treatment that the physician does not deem medically necessary.
Answer 3: Zidovudine is a nucleoside reverse-transcriptase inhibitor (NRTI) used in the treatment of HIV.
Answer 4: Referring the patient to another physician is rarely the correct answer on the USMLE.

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