A 34-Year-Old Man Comes to the Office with a 5-Day

A 34-year-old man comes to the office with a 5-day history of nasal congestion and cough.  He says that he occasionally coughs up thick, yellow sputum and is worried about the lack of improvement.  The patient mentions that he has received antibiotics for similar symptoms in the past and says, "Antibiotics always seem to help me feel better fast."  Temperature is 37.2 C (99 F) , blood pressure is 120/70 mm Hg, pulse is 76/min, and respirations are 18/min.  Physical examination shows pharyngeal erythema; the remainder of the examination, including cardiopulmonary evaluation, is normal.  Which of the following responses by the physician is most appropriate?

A) "Although you've experienced improvement with antibiotics in the past, your symptoms will likely improve with over-the-counter treatment."
B) "Antibiotics can be helpful for certain infections, but I'm concerned you may have been prescribed antibiotics inappropriately in the past."
C) "Feeling sick is unpleasant; let's talk about why antibiotics are not recommended and what treatments can help you feel better."
D) "I understand why you want me to prescribe antibiotics, but this would only lead to antibiotic resistance."
E) "Many patients think antibiotics can help treat colds; unfortunately, there are no quick fixes for viral infections."

Correct Answer:

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