Problem: Current treatment guidelines for acute bacterial rhinosinusitis in adults considers first-line therapy to be amoxicillin either with or without clavulanate, depending on whether risk factors for antibiotic resistance are present. Which of the following is NOT a risk factor? 1. antibiotic use in past 30 days 2. severe infection with systemic symptoms such as a fever greater than 102 3. age under 60 4. recent hospitalization, or immunocomprised status