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Adductor strain — MRCGP AKT MCQ

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HardSoft Tissue InjuryAdductor strainMRCGP AKT

A patient with COPD has completed the appropriate safety assessment and starts prophylactic azithromycin for frequent exacerbations. At what point should clinical benefit first be formally reviewed?

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Correct answer: B — After 3 months, followed by reviews at least 6-monthly

The best answer is “After 3 months, followed by reviews at least 6-monthly”. NICE advises reviewing prophylactic azithromycin after the first 3 months and then at least every 6 months. The review should assess exacerbation frequency, quality of life and adverse effects, with treatment continued only when benefit justifies ongoing antimicrobial and cardiac, hepatic or auditory risk. Diarrhoea, hearing or balance disturbance and QT-related concerns need active safety-netting. The pre-treatment microbiology, ECG, liver tests and imaging bundle does not remove the need for an early response review and continuing stewardship.

Reference: NICE NG115: Chronic obstructive pulmonary disease in over 16s: https://www.nice.org.uk/guidance/ng115/chapter/recommendations