The daughter of an older patient with chronic bronchitis says to the nurse, "I don't understand why my father has not been prescribed antibiotics for his bronchitis. The last time I had bronchi-tis I got antibiotics."
The nurse considers the following when formulating a response:
a. Antibiotics tend to be less effective in older adults than in younger adults.
b. Antibiotics are not prescribed in chronic bronchitis since the cause is usually not bacterial.
c. The routine use of antibiotics is controver-sial because the causal role of bacterial in-fection is often not clear.
d. Normal age-related decreases in immune response delay the presentation of classic symptoms.
ANS: C
In chronic bronchitis, the routine use of antibiotics is controversial because the causal role of bacterial infection is often difficult to document. Antibiotics are generally indicated in frail el-ders when the possibility of pneumonia or an acute exacerbation of bronchitis is suspected. There is no evidence that antibiotics are less effective in older adults or that chronic bronchitis is usually caused by a nonbacterial cause. While it is correct that a normal age-related decreased immune response may delay the presentation of classic symptoms, this does not explain why antibiotics are often not prescribed.
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