skip to main content

Macrolide Prophylaxis — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

HardAntimicrobial StewardshipMacrolide ProphylaxisSCE Infectious Diseases

A patient with frequent COPD exacerbations is considered for long-term azithromycin after inhaled therapy and pulmonary rehabilitation are optimised. What must be completed first?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — ECG and liver tests, hearing counselling and sputum assessment including non-tuberculous mycobacteria

The best answer is “ECG and liver tests, hearing counselling and sputum assessment including non-tuberculous mycobacteria”. Baseline QTc, liver function, hearing risk and sputum microbiology reduce avoidable harm; macrolide monotherapy can select resistance in unrecognised NTM infection. Long-term macrolide therapy requires optimisation of standard care, ECG and liver assessment, hearing counselling and sputum evaluation including non-tuberculous mycobacteria. NTM pulmonary disease requires compatible clinical-radiological disease and microbiological criteria, followed by species-directed multidrug therapy.

Reference: BTS guideline for long-term macrolides in adults with respiratory disease: https://bmjopenrespres.bmj.com/content/7/1/e000489 BTS guideline for non-tuberculous mycobacterial pulmonary disease: https://thorax.bmj.com/content/72/Suppl_2/ii1