During an acute gouty flare, which strategy is least likely to improve symptoms?

In the context of treating an acute gouty flare, probenecid is the least effective choice among the options provided because its primary role is to prevent future gout attacks rather than alleviate the symptoms of an acute flare. Probenecid works by inhibiting the reabsorption of uric acid in the kidneys, thereby promoting its excretion. This helps to lower uric acid levels in the long term but does not have a rapid effect on the inflammation and pain associated with an acute gout attack.

On the other hand, naproxen, colchicine, and prednisone are all effective for managing acute gout flares. Naproxen is a non-steroidal anti-inflammatory drug (NSAID) that helps to reduce pain and inflammation quickly. Colchicine can help alleviate pain and reduce inflammation as well by disrupting the inflammatory process during a gout attack. Prednisone, a corticosteroid, is also effective in reducing inflammation and can be particularly helpful in cases where NSAIDs or colchicine are not suitable.

Therefore, probenecid's role in managing long-term uric acid levels makes it less suitable for improving the symptoms during an acute episode compared to the other available treatment options.