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Antibiotic delayed prescription — GPhC CRA MCQ

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

HardInfectionsAntibiotic delayed prescriptionGPhC CRA

A 6-year-old with acute otitis media is systemically well, has mild unilateral pain for one day, no otorrhoea and no high-risk comorbidity. A back-up antibiotic prescription is chosen. When should the parent be told to use it?

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

Reveal the answer and explanation

Correct answer: A — If symptoms rapidly or significantly worsen, or do not begin to improve within 3 days

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · C = shown as D · B = shown as E

A conflicts with the selective antibiotic strategy for a well child without otorrhoea or other higher-benefit features. B does not allow adequate time for analgesia or natural resolution. C is wrong because routine ear swabbing is not required. D would expose a recovered child to unnecessary antibiotic. E is correct; parents should also use appropriate analgesia and seek reassessment sooner for marked deterioration, systemic illness or complications.

Reference: NICE NG91: Acute otitis media—antimicrobial prescribing. https://www.nice.org.uk/guidance/ng91/chapter/Recommendations