A patient with otitis media is treated for 10 days with amoxicillin. At the follow-up visit, the primary care NP notes bilateral erythematous, bulging tympanic membranes. The NP should prescribe:
a. intramuscular injection of penicillin G (Bicillin).
b. amoxicillin for 10 more days.
c. oral dicloxacillin (Dynapen) for 10 days.
d. oral amoxicillin-clavulanate (Augmentin) for 10 days.
D
Antibiotic resistance to penicillins occurs through three mechanisms, the most important being bacteria producing B-lactamase, which breaks down the B-lactam ring and renders the penicillin inactive. Clavulanic acid, used in combination with penicillins, prevents this inactivation. The NP should prescribe amoxicillin-clavulanate. Giving 10 more days of amoxicillin would not be effective. Dicloxacillin is used when resistance is caused by penicillinase-resistant staphylococcal infection. Penicillin G is not used to treat otitis media.
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Answer the following statement true (T) or false (F)