It would seem that the patient is getting better. De-escalating the antibiotics to a narrower spectrum would seem appropriate for a number of reasons (reduce incidence of resistance, cost, convenience to start with). Remember broad spectrum antibiotics are not “stronger”
Amoxicillin or Trimethoprim would seem reasonable options orally or iv, although it would seem that iv is not what the patient would want (shared decision making time here maybe…..if the patient still had a temperature and the bugs were only pip/tazo sensitive this might be a different conversation) and oral would have a number of advantages
Going home would seem an entirely appropriate decision...and something we should aim for as soon as we can for everyone.
In order to get some prescribing resources out there we intend to publish a series of prescribing problems on the website. The problems will appear at least weekly with the "answers" appearing a couple of days later. We'll use the standard exam stationery available on the LSE, but also available below in case you haven't got access to the LSE.