Medical history 6-year-old female patient admitted due to cough with purulent secretion for 2 weeks, fever, hypoxia, weight loss and 11% decline in FEV1 (forced expiratory volume in the first second). On physical examination: Respiratory Rate=30, Oxygen Saturation=96% in room air and bilateral coarse crackles on auscultation of the lungs. Previous diagnosis of cystic fibrosis, reports chronic cough. Chronically colonized by P. aeruginosa - positive culture of 3 weeks ago. Radiographs and high resolution computed tomography (HRCT) of the chest were requested. Image 1: Chest radiograph, posteroanterior (PA) projection.Image 2: Chest radiograph, lateral projection.Image 3: High resolution computed tomography (HRCT) of the chest, axial section, supracarinal level, without intravenous injection of contrast medium, lung window.Image 4: High resolution computed tomography (HRCT) of the chest, axial section, infracarinal level, without intravenous injection of contrast medium, lung window. Question:Considering the clinical history and the imaging exams, which of the alternatives below describes the most appropriate medical approach? Hospitalization and prescribe intravenous antibiotic therapy with oxacillin or vancomycin. Hospitalization, collect sputum sample for culture and prescribe intravenous antibiotic therapy with 2 or more antibiotics, at least one beta-lactam and one aminoglycoside. Collect sputum sample for culture and prescribe oral antibiotic therapy with ciprofloxacin. Hospitalization, collect sputum sample for culture and prescribe intravenous antibiotic therapy with clindamycin. Time is Up! Time's up
