Question

A patient comes into the office with complaints of unilateral facial pain, upper molar pain and nasal congestion. She states that it began two days ago and she can't lay down to sleep. She denies fever, shortness of breath, nausea or vomiting. What is the best course of action for this patient?

a. Prescribe the patient amoxicillin-clavulanate (Augmentin)
b. Prescribe the patient levofloxacin
c. Prescribe the patient cefdinir (Omnicef)
d. Symptomatic treatment

Answer 1

The best course of action for this patient is symptomatic treatment, as it is likely that she is experiencing sinusitis. Sinusitis is often self-limiting and can improve within 1-2 weeks without the need for antibiotics.

Step-by-step explanation:

The best course of action for this patient is symptomatic treatment. Based on the patient's symptoms of unilateral facial pain, upper molar pain, and nasal congestion, along with the absence of fever, shortness of breath, nausea, and vomiting, it is likely that she is experiencing sinusitis. Sinusitis is commonly caused by viral infections and is often self-limiting, with symptoms improving within 1-2 weeks without the need for antibiotics. Symptomatic treatment can include over-the-counter pain relief medications, nasal decongestants, and saline nasal rinses to relieve pain and congestion.

Answer 2

The patient should start with symptomatic treatment for the unilateral facial pain, upper molar pain, and nasal congestion. Antibiotics such as amoxicillin-clavulanate might be considered if symptoms are severe or persistent, but careful monitoring before prescribing is important.

Step-by-step explanation:

When a patient comes into the office with complaints of unilateral facial pain, upper molar pain, and nasal congestion, and describes difficulty lying down to sleep but denies fever, shortness of breath, nausea, or vomiting, this could be indicative of a sinus infection or sinusitis. In the absence of fever and other systemic symptoms, the best course of action for this patient may be to start with symptomatic treatment, such as nasal decongestants, saline nasal spray, and pain relief. Antibiotics like amoxicillin-clavulanate could be considered if symptoms are severe or if they persist despite symptomatic treatment, suggesting a possible bacterial infection. However, without signs of bacterial infection, it is often prudent to avoid unnecessary antibiotic use and monitor the patient's symptoms closely before prescribing them.