QuestionSBA
QuestionChoice
This is not appropriate as the patient has signs and symptoms of a community acquired pneumonia, which should be treated with appropriate antibiotics.
10028315
e
Advise a 'watch and wait' strategy
QuestionChoice
There are no 'red flags' indicating hospital admission, e.g. hypoxia or evidence of respiratory distress. This patient's CRB-65 score is 0, indicating a low risk of mortality.
10028312
b
Arrange hospital admission
QuestionChoice
This is the most appropriate course of action. This patient has signs of a community acquired pneumonia, with a CRB-65 score of 0, indicating a low risk of mortality. Antibiotics should be prescribed. As he reports a penicillin allergy, clarithromycin or doxycycline are appropriate agents.
10028311
a
Prescribe clarithromycin
QuestionChoice
This would not be an appropriate choice of antibiotic, not only as the patient reports a penicillin allergy, but also as amoxicllin/doxycycline/clarithromycin are the first choice antibiotics in community acquired pneumonia, not co-amoxiclav.
10028313
c
Prescribe co-amoxiclav
QuestionChoice
This would not be an appropriate antibiotic combination. Either doxycycline OR clarithromycin should be prescribed for the treatment of community acquired pneumonia in penicillin allergy.
10028314
d
Prescribe doxycycline and clarithromycin
Concept
Chapter
2693
6051
Pneumonia (Infectious Diseases)
Topic
162
General practice
18060
In community-acquired pneumonia, clarithromycin is a suitable antibiotic alternative for patients with a penicillin allergy.
A 43-year-old man visits his GP with a 3-week history of a cough. Recently, he has been bringing up yellow sputum. He has no chest pain and no significant medical history. He believes he may be allergic to penicillin.

On examination, he has crackles in the right basal zone of the lungs. Observations are as follows:

* Heart rate: 62 beats/minute
* Blood pressure: 140/66 mmHg
* Respiratory rate: 16 breaths/minute
* Temperature: 37.9 degrees
* Oxygen saturations (room air): 98%

What is the most appropriate course of action to take?
a