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6 years ago
A patient has confirmed Rocky Mountain spotted fever, and the infectious disease specialist is treating the patient with doxycycline 100 mg orally for 7 days.
 
  The patient comes to the clinic for follow-up care with the primary care NP at the end of therapy and reports continued fever, headache, and myalgia. The NP will consult with the infectious disease specialist and order: a. 7 more days of doxycycline.
  b. erythromycin 250 mg four times daily for 7 days.
  c. amoxicillin 500 mg three times daily for 10 to 14 days.
  d. hospital admission for intravenous chloramphenicol.
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#1
6 years ago
D
With treatment, the patient's condition should start to improve in 2 to 3 days. Continued elevation of the temperature may indicate lack of efficacy or drug fever. Chloramphenicol is used to treat Rocky Mountain spotted fever. It is not correct to continue therapy with doxycycline because treatment failure is likely. Erythromycin is used to treat Lyme disease. Amoxicillin is not indicated.
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