12-03-2008, 04:14 AM
A 70-year-old male is brought to the emergency department by his daughter with a two-day history of fever, chills and productive cough. In the past few hours, he developed altered mental status. His past medical history is significant for hypertension and diabetes mellitus, type 2. His current medications are hydrochlorothiazide, enalapril and glyburide. He smokes one pack a day and consumes alcohol occasionally. His temperature is40C (103F), blood pressure is 80/50 mm Hg, pulse is 130/min, and respirations are 32/min. Pulse oximetry shows 76% on room air. Breath sounds are decreased over the right middle and left lower lobes. Which of the following is the best treatment option for this patient?
ยข A. Oral clarithromycin and outpatient care
c B. Hospitalization and cefotaxime
c C. Hospitalization, cefotaxime plus gentamycin
c D. Hospitalization, ceftriaxone plus azithromycin
c E. Hospitalization, cephalexin plus clarithromycin
ยข A. Oral clarithromycin and outpatient care
c B. Hospitalization and cefotaxime
c C. Hospitalization, cefotaxime plus gentamycin
c D. Hospitalization, ceftriaxone plus azithromycin
c E. Hospitalization, cephalexin plus clarithromycin