Since 1990 the percentage of bacterial sinus infections in Aqadestan

Question

Since 1990 the percentage of bacterial sinus infections in Aqadestan that are resistant to the antibiotic perxicillin has increased substantially. Bacteria can quickly develop resistance to an antibiotic when it is prescribed indiscriminately or when patients fail to take it as prescribed. Since perxicillin has not been indiscriminately prescribed, health officials hypothesize that the increase in perxicillin resistant sinus infections is largely due to patients’ failure to take this medication as prescribed.

Which of the following, it true of Aqadestan, provides most support for the health officials' hypothesis:

(A) Resistance to several other commonly prescribed antibiotics has not increased since 1990 in Aqadestan

(B) A large number of Aqadestanis never seek medical help when they have a sinus infection.

(C) When it first became available, perxicillin was much more effective in treating bacterial sinus infections than any other antibiotic used for such infections at the time.

(D) Many patients who take perxicillin experience severe side effects within the first few days of their prescribed regimen

(E) Aqadestani health clinics provide antibiotics to their patients at cost

ID: 500297
CR06422

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ankurgupta03 · Accepted Answer

Since 1990 the percentage of bacterial sinus infections in AQADESTAN that are resistant to the antibiotic perxicillin has increased substantially. Bacteria can quickly develop resistance to an antibiotic when it is prescribed indiscriminately or when patients fail to take it as prescribed. Since perxicillin has not been indiscrimhately prescrIbed, health officials hypothesize that the increase in perxicillin resistant sinus infections is largely due to patients’ failure to take his medication as prescribed.

Premise  : Resistant bacteria increase due to 
1. when perxicillin is prescribed indiscriminately
2. when patients fail to take perxicillin as prescribed
But we know that perxicillin has not been indiscrimhately prescribed

Intended Hypothesis : perxicillin resistant sinus infections is largely due to patients’ failure to take his medication as prescribed and not because of indiscriminate prescription.

Which of the following, it true of Aqadestan, provides most support for the health officials hypothesis? 
So we have to find choices that support our intended hypothesis and negate the once that oppose this.

A) Resistance to several other commonly prescribed antibiotics Ins not increased since 1990 in Aoadestan.
 This is not related to the premise as the other antibiotics are not in consideration.

B) A large number of Aqadestanis never seek medical help when they have a sinus infection.
 This might in some way lead to indiscriminate prescription, hence can be ruled out.

C) When it list became available, perxicillin was much more effective in treating bacterial sinus infections than any other antibiotic used for such infections at the time.
 This talks about effectiveness and does not tell us anything related to the two cases at hand. Hence it can be ruled out.

D] Many patients who take perxicillin experience severe side effects within the ﬁrst few days of their prescribed regimen.
 This suggests that the patients might have stopped taking the antibiotic after the severe side effects. Hence the correct answer

E) Aqadestani health clinics provide antibiotics to their patients at cost.
 Not related.

WaterFlowsUp · Answer

what Ankurgupta03 is saying is here is totally correct( and ankur . I will just like to add on to option B.

B) A large number of Aqadestanis never seek medical help when they have a sinus infection.
 This option can go in any of the ways mentioned below
i) Patients take perixicillin
ii) patients dont take perxiccilin but take some other medicine
iii) patients dont take medicine at all.

In all of those situations, it is very tough to make any decision
So B is inconclusive

WillGetIt · Answer

Hello Waterflowsup,

I just want to add my point regarding B.

If we follow the rule of sticking to "conclusion" of argument we may even not require further reasoning regarding B. Lets see how.

Argument: There are two reasons X and Y for the certain outcome. There are very less changes of reason X, so reason Y would probably be reason behind outcome.

Question Stem: Strengthen?

Now if we consider B, it states "A large number of Aqadestanis never seek medical help when they have a sinus infection".

Option B and reasoning (patients’ failure to take his medication as prescribed) behind arguments is not same. If anything B is doing, it is just undermining the given premise by stating that medicines are generally not prescribed because people never seek medical help.

If we see choice B is actually out of scope.

Hope it helps.

Regards
Vikas

manishcmu · Answer

I usually focus on the conclusion while selecting the correct answer. The conclusion on this question is failure to take medication (cause) led to sinus infection(effect). So I looked for an answer choice that supports this cause -effect relationship. But, the correct answer states the cause of the failure to take medication and not that failure to take medication resulted in sinus infection. i missed the answer choice due to this thought process.Is there something wrong in my approach?

abhimahna · Answer

Conclusion : the increase in perxicillin resistant sinus infections is largely due to patients’ failure to take his medication as prescribed.  Note that Its not that they are not taking the medications but they are not taking as suggested. 
 
The argument states Bacteria can develop resistance in two cases :
1) antibiotic prescribed indiscriminately
2) patients fail to take it as prescribed.

Now, Point 1 has been ruled out by the argument itself.

Hence, to strengthen the argument we need to strength that 2nd point happened.

Answer choice D clearly states that when they start taking the antibiotics, they experience severe side effects.Hence, telling us the reason that theu avoid such prescriptions. Hence a strengthener.

KARISHMA315 · Answer

I selected B thinking that as many are using medicine without going to the doctor, they would not know the prescribed regimen and hence would not be following it. Please tell how this is wrong

anje29 · Answer

Hi, The conclusion here is ' the increase in perxicillin resistant sinus infections is largely due to patients’ failure to take his medication as prescribed. ' To support this point the paraphrase would be that though doctor has asked patient to take medicine as per prescription the patient is not taking as per prescription. In option B patients are not consulting doctor , so they do not have any prescribed regimen to take medicine at first place. Option D states the gap to reach the conclusion ( why conclusion could be true) . If patients will feel severe side effects from the prescribed regimen then they would certainly going to not follow it as prescribed. Basically you have to choose best among the others my friend

. No other choice come close to the conclusion as option D.

urhowig · Answer

I couldn't find a proper explanation for option B. Besides that I was quite demotivated to choose the wrong answer. I choose option B.
But after re-reading the conclusion part,  the increase in perxicillin resistant sinus infections is largely due to patients’ failure to take his medication as prescribed  
I finally got some clue.
If you notice that the above conclusion mentions " ...as prescribed. ". What it might mean is that the patients about whom the author concludes might have already consulted the doctor. So, the scope of the argument is only "patients who have consulted the doctor".
This clearly makes option B out of scope.
I hope this helps others.

pushkarajnjadhav · Answer

Conclusion : Since 1990 the percentage of bacterial sinus infections in AQADESTAN that are resistant to the antibiotic perxicillin has increased substantially.

Premise  : This problem has occurred because of
A) when perxicillin is prescribed indiscriminately.
B) when patients fail to take perxicillin as prescribed.

Additional Premise : Perxicillin has not been indiscriminately prescribed.
To support the author's claim, we must find a statement that supports premise A.

A) Resistance to several other commonly prescribed antibiotics has not increased since 1990 in Aqadestan.
 Out of scope, as we are not talking about any other antibiotics.

B) A large number of Aqadestanis never seek medical help when they have a sinus infection.
 out of scope, as we are not discussing about people who never seek medical help for their sinus infection.

C) When it first became available, perxicillin was much more effective in treating bacterial sinus infections than any other antibiotic used for such infections at the time.
 This actually weakens the argument. This statement implies that bacteria has grown used to perxicillin and perxicillin is not as effective as it was back then.

D) Many patients who take perxicillin experience severe side effects within the ﬁrst few days of their prescribed regimen.
 Yes, This is the answer. It implies that many patients stopped taking perxicillin because of initial side effects; that means they did not complete the course as prescribed.

E) Aqadestani health clinics provide antibiotics to their patients at cost.
 out scope. Eliminate it.

Kudos if it helps.

XyLan · Answer

vijaisingh2001 , quite an inference.
Let's deep-dive!

Conclusion:  
Of the two reassons - 
 1) indiscriminate prescription 
2) patient's failure to take it as prescribed.
 We are zeroing on patient's failure to take the medicine as prescribed ----- led to ----> the INCREASE in perxicillin resistant sinus INFECTIONS.
 failure to take the medicine(  Cause  ) ------> INCREASE in perxicillin resistant sinus INFECTIONS(  Effect  )

Pre-Think:  
Any statement indicating that the antibiotic was NOT taken as per the doctors’ prescription will strengthen our belief in the conclusion.

Answer choice analysis:   
(A) Resistance to several  OTHER  commonly prescribed antibiotics has not increased since 1990 in Aqadestan
   A talks about OTHER commonly prescribed antibiotics. OUT!   
(B) A large number of Aqadestanis  NEVER SEEK  medical help when they have a sinus infection.
   B talks about people who never seek medical help when they have a sinus infection. 
we NEED to concentrate only on the people who consult doctors and have seeked medical help. OUT!  
 (C) When it first became available, perxicillin was much more effective in treating bacterial sinus infections than any other antibiotic used for such infections at the time.
   Perxicillin WAS more effective than OTHERS when it was introduced. 
A likely inference: Perxicillin is NO longer MORE effective than OTHERS.
Thus, C highlights that the effectiveness of the medicine has degraded, leading to a 3rd factor for the  probable  cause of the increase in sinus infections - A weakener. OUT!
 lower effectiveness of the medicine(  Cause  ) ------> INCREASE in perxicillin resistant sinus INFECTIONS(  Effect  ) - An alternate cause   
 (D) Many patients who take perxicillin experience  SEVERE  side effects within the ﬁrst few days of their prescribed regimen
  The side effects are SEVERE(  A contextually vital information ). Quite likely, the patients would be NOT in favor of continuing the usage of the prescribed medicine.
This part CAN highlight that the antibiotic was NOT taken as per the doctors’ prescription.
A contender. Keep it!

(E) Aqadestani health clinics provide antibiotics to their patients at cost
  It does NOT matter whether the patients are receiving the antibiotics  at cost , as long as the patients are receiving the medicine.
Does NOT explain the rise in increased bacterial sinus infections.

To answer your query:  
   Let's say - the efficiency of the medicine when introduced was 90%.
Now, efficiency has reduced.

However, Are we SURE that the reduction in efficiency of the medicined is so discerning that patients would simply  boycott  taking the medicine?
The impact of C is  dicey  at best because the reduced efficiency can be either  80%  or  a tiny 5% .

This is the inference where you did the mistake -  side effects were there early too when the medicine was launched . 
How CAN we be sure of this part that the side effects were there early too?
You have passed on the info of OptionC to OptionD because while reading OptionC, it gave you the context of the  change in the side effects ( OptionD), just like  a change in the efficiency. ( OptionC)

Moreover, OptionD states that Many patients who take perxicillin EXPERIENCE(  present-tense  ) SEVERE side effects within the ﬁrst few days of their prescribed regimen.
 The patients  currently  suffer from  SEVERE  side effects, a point that highlights their  unfavorability  to continue the prescribed regimen.

TakeAway:  
  vijaisingh2001 , you lose this question  not because  you don't know how a strengthener works(   Infact, I believe you very well do!  ),  but because  you did an  inference mistake  of the right answer choice. 
An unintended, yet  costly  mistake in GMAT.
Always read the answer choices in  isolation  and then  discern their impact .

KarishmaB · Answer

- Percentage of infections that are resistant to perxicillin has increased substantially. 
- This can happen when it is prescribed indiscriminately or when patients fail to take it as prescribed. 
- perxicillin has not been indiscriminately prescribed,

Conclusion: Patients do not to take this medication as prescribed.

We need to strengthen the conclusion. Something that says that patients who are prescribed this medicine do not take it properly. That this is the reason for increased resistance. Note that there could be a 100 other reasons so eliminating one other would barely strengthen this but that is a call we will take as per our options.

A) Resistance to several other commonly prescribed antibiotics has not increased since 1990 in Aqadestan

One way to look at it is that there doesn't exist one other common reason because of which resistance is developing against all antibiotics but that barely strengthens our argument. Another way to look at it is that people are taking other antibiotics as prescribed since resistance to them is not increasing. Then it is unlikely that they are not taking perxicillin as prescribed. This actually weakens our argument.

B) A large number of Aqadestanis never seek medical help when they have a sinus infection.

People who are not prescribed perxicillin are irrelevant.

C) When it first became available, perxicillin was much more effective in treating bacterial sinus infections than any other antibiotic used for such infections at the time.

Tells us that perxcillin was the best at one time. Doesn't impact our argument.

D) Many patients who take perxicillin experience severe side effects within the ﬁrst few days of their prescribed regimen

This provides a good reason why people may not be taking perxicillin as prescribed. Then it certainly strengthens the conclusion that patients not taking the medicine as prescribed is the reason for increased resistance.

E) Aqadestani health clinics provide antibiotics to their patients at cost

Irrelevant.

Answer (D)

shanks2020 · Answer

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I believe and Know side effects are normal for some drugs. They are even on the drug notice so I don't understand this..
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Hi  VeritasKarishma

I am not able to get my head around option D. How and why do we assume the the patient will stop taking the antibiotics. Yes, there is severe side effects, but then he may choose to bear it and go ahead and complete the course, or another possibility is that he takes some other medicine to reduce the side effects?
This is a streghtner question, then why do we have to assume things?

If that is the case, then even option B can be strengthener. Why? because people don't seek medical help, that means there is chance that they take medicines on their own(without prescription) and hence don't know the dose. The argument clearly mentions 2 reasons : one reason is "prescribed" antibiotics. So this is not prescribed, hence it strengthens the alternate reason.

Kindly explain this conundrum.

KarishmaB · Answer

"Patients do not take it as prescribed" is not an assumption. It is the given conclusion. We need to strengthen this conclusion so we need to increase the probability that it is correct. Now, if we are given a reason why people may not take it as prescribed, it will strengthen our conclusion. 
Severe side effects could be one such reason. It increases the probability that people do not take it as prescribed. 
Another reason could be say one needs to take it every 3 hrs so people skip it at night. Again, gives a reason why people may not take it as prescribed and could be another strengthener.

ahujaparth10 · Answer

Hi.

kindly clear my query.

As per my understanding, the health official's hypothesis is that the bacteria resistance can be due to 2 reasons - 1) Indiscriminately Prescribed or 2) Failiure to take the medication as prescribed. (1) is eliminated, and hence we have to strengthen the hypothesis that it is indeed (2).

Now, (D) tells us that the patients have side effects. How can we assume that the side effects lead to a patient taking the medication irregularly? The patient is as likely to continue taking the medication irrespective of any side effects.

(C) tells us that when the drug first became available, was *more effective* than any other drug. Doesn't this rule out an alternate possibility of the drug being originally ineffective, and thus strengthen/support the original hypothesis that the resistance is indeed due to patient's failure to take the medication as prescribed?

MartyTargetTestPrep · Answer

That possibility has already been ruled out. The passage says, "Since 1990 the percentage of bacterial sinus infections in AQADESTAN that are resistant to the antibiotic perxicillin  has increased substantially ." So, we know for sure that there has been a change in the effectiveness without (C).

(D) does not prove for sure that they are failing to take the medication as prescribed, but the fact that the medication has "severe side effects" is certainly a reason to suspect that at least some people fail to take it as prescribed.

Patilsv28 · Answer

Hi  GMATNinja   VeritasKarishma

Could you please help in eliminating answer choice C. My reasoning behind marking C is as below:

Above choice says perxicillin was effective when it became available. We know from the argument there can be only 2 reasons for perxicillin to be ineffective.
1. when perxicillin is prescribed indiscriminately
2. when patients fail to take perxicillin as prescribed.

But we know from the argument perxicillin was not prescribed indiscriminately. So we can clearly say that increase in perxicillin-resistant sinus infections is largely due to patients' failure to take this medication as prescribed. So this answer choice also supports health officials' hypothesis.

Please correct my conceptual gap.

Thanks in advance.

KarishmaB · Answer

Don't get lost in the argument. To strengthen it, strengthen the conclusion.

The conclusion is : Patients do not to take this medication as prescribed.
This is what you need to strengthen. How does (C) strengthen it? Because the medicine was most effective initially, why would patients not take it as prescribed?

Nerdy01 · Answer

Hi  VeritasKarishma  ,

What I don't get is how do we eliminate E?

In case of D, we assume that people got fed up of the side effects and didn't take the prescribed medicine.

By applying the same logic to E, people were too poor to buy the antibiotics. As a result, they didn't drink the prescribed medicine

Posted from my mobile device

KarishmaB · Answer

How does (E) imply that the medicine is very expensive?

"at cost" means without charging profit. So they give those antibiotics at the same cost at which they are manufactured. Whether that cost is high or low we don't know. We are just given that the clinics don't take any profit.

Since 1990 the percentage of bacterial sinus infections in Aqadestan

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Since 1990 the percentage of bacterial sinus infections in Aqadestan

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