Case Studies

MARCH 17, 2014
Craig I. Coleman, PharmD
Case 1
SW is a 15-year-old girl who comes to your pharmacy’s urgent care clinic with her mother on a wintry day. SW complains of a sore throat that came on quickly overnight, a headache, and some nausea. She says that she does not have a cough or diarrhea. The nurse practitioner examines SW, finding that her temperature is 101.3°F and seeing patchy tonsillopharyngeal exudates in the back of SW’s throat. A throat swab is performed and a rapid antigen-detection test for group A beta-hemolytic Streptococcus (GAS) produces a positive test result. SW is allergic to penicillin.
Which antibiotic would you suggest be prescribed to treat SW’s GAS pharyngitis?

Case 2
SC is a 49-year-old woman who comes to your pharmacy’s urgent care clinic complaining of persistent facial congestion and pressure; stuffy nose; fatigue; and purulent, discolored nasal discharge for the past 2 weeks. Examination by the nurse practitioner finds that SC has a fever of 102°F. The nurse practitioner makes an empirical diagnosis of acute bacterial rhinosinusitis (ABRS). SC has no known drug allergies.
What treatment regimen would you suggest for SC’s rhinosinusitis?
Dr. Coleman is professor of pharmacy practice, as well as codirector and methods-chief at Hartford Hospital Evidence-Based Practice Center, at the University of Connecticut School of Pharmacy.


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