If a sputum gram stain reveals the presence of gram-negative bacilli, what is the recommended therapy?

The recommended therapy when a sputum gram stain reveals the presence of gram-negative bacilli is antimicrobial therapy. This is because gram-negative bacilli are typically associated with bacterial infections that could affect the respiratory system, such as pneumonia or bronchitis. Antimicrobial therapy is specifically designed to target and eliminate bacterial pathogens, which is essential to effectively treat the infection indicated by the presence of these bacteria.

Other treatments, such as bronchodilator therapy and inhaled corticosteroids, are generally used for management of chronic conditions like asthma or chronic obstructive pulmonary disease (COPD) and are not effective against bacterial infections. Antihistamines are typically used to treat allergic reactions and do not address bacterial infections either. Therefore, antimicrobial therapy is the most appropriate and effective response to ensure that the underlying bacterial infection associated with the gram-negative bacilli is treated properly.