What is the best treatment plan for a 68-year-old man presenting with fever and productive cough, alongside a chest X-ray showing an infiltrate in the right lower lobe?

The most appropriate treatment plan for this 68-year-old man, who presents with fever, productive cough, and an infiltrate in the right lower lobe on chest X-ray, is to admit him to the hospital and initiate empiric antibiotics. This decision is based on several important factors.

Given the patient's age and the presence of a productive cough accompanied by fever, it raises concern for pneumonia, which is a common consideration in this demographic. The infiltrate observed in his chest X-ray further supports this diagnosis. Treating pneumonia typically requires antibiotics to target the suspected organisms, which can vary depending on local antibiotic resistance patterns, patient history, and other factors.

Admission is warranted not only due to the possible severity of pneumonia in older individuals but also because they are more prone to complications such as respiratory failure or sepsis. Empiric antibiotics are tailored to cover the most common pathogens responsible for community-acquired pneumonia, such as Streptococcus pneumoniae and others, which is critical for effective treatment and improved patient outcomes.

Other treatment options, while they may have their merit in different scenarios, do not adequately address the seriousness of the patient's condition. Simply managing symptoms would overlook the need for immediate treatment of the underlying cause. A cough suppressant is not recommended as