American Board of Internal Medicine (ABIM) Certification Practice Exam

Antibiotics should only be used in upper airway cough syndrome when there is evidence of which condition?

1. Viral infection

2. Allergic rhinitis

3. Bacterial infection

4. Sinusitis

The correct answer is: Bacterial infection

Antibiotics are specifically effective against bacterial infections. In the context of upper airway cough syndrome, which often arises from conditions like viral infections or allergic responses, the use of antibiotics is warranted only when there is clear evidence of a bacterial infection. This is because viral infections, which are the most common cause of upper respiratory symptoms, do not respond to antibiotics and may lead to unnecessary side effects or antibiotic resistance if prescribed indiscriminately. In cases of sinusitis, while it can be caused by both viral and bacterial infections, antibiotics are only recommended for bacterial sinusitis when symptoms are severe, persistent, or worsening after an initial period, typically around 10 days. Thus, providing evidence of a bacterial infection is a crucial factor in deciding to initiate antibiotic therapy in patients with upper airway cough syndrome.