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August 2014

Balancing the Benefits and Risks of Empirical Antibiotics for Sinusitis: A Teachable Moment

Author Affiliations
  • 1Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado
  • 2Department of Emergency Medicine, University of Colorado Hospital, Aurora
JAMA Intern Med. 2014;174(8):1221-1222. doi:10.1001/jamainternmed.2014.2124

A man in his 70s with a history of rheumatoid arthritis being treated with infliximab presented to his primary care physician (PCP) with upper respiratory tract congestion of several days’ duration. He was diagnosed as having acute rhinosinusitis and treated with cefdinir. Two days later, he developed diarrhea. After 24 hours of severe diarrhea, he discontinued taking the antibiotic, and the following day his physician prescribed the combination drug diphenoxylate hydrochloride/atropine sulfate (Lomotil; Pfizer Inc).

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