• Fever – onset, course, does patient feel unwell within themselves.
• Other localising symptoms – cough, coryza, nausea/vomiting, diarrhoea, dysuria, urinary frequency, arthralgia, myalgia, any pain?
• Constitutional symptoms – lethargy, weight loss, anorexia, night sweats, lymphadenopathy?
• Antibiotic therapy:
  • Intravenous and oral drugs, dose, dates, reason for changing.

Surgical Patients:

• Surgical procedures and intra-operative findings. (E.g. did it look infected, did they debride/resect all the infected tissue?)
• Is there any prosthetic materials underlying that is it still in situ?
• Future surgical plans.

Other information:

• Overseas travel and timing (migration)
• Previous infections
• Previous surgeries and hardware that remains
• Sick contacts
• Animal contacts
• Unusual hobbies (gardening, water sports, hiking, fishing)
• Occupation
• Latent infection screening (if immunosuppressed or starting immunosuppression – TB, hepatitis B)
• Vaccination status (in particular if immunosuppressed – pneumococcal, influenza, varicella)
• Asplenia (vaccination and prophylaxis)
• Duration of neutropenia and expected recovery
• IVDU
• Sexual history

• Septic screen – urinalysis, urine MCS, chest x-ray, blood cultures (ideally before antibiotics), stool MCS and c diff (especially if on antibiotics).
• CRP and WCC can be used to monitor patients, but often are not required more than 1-2x a week in a stable patient (CRP is never useful as a daily test).
• Renal and liver function is important given many antibiotics affect renal and liver function.
• Imaging:
  • Chest x-ray
  • Bone x-ray if concern for OM
  • We can always help guide regarding CT/MRI/bone scan, etc.
• Previous and current microbiology results:
  • Source, organism and sensitivities, treatment?
• MRSA, VRE, MRGN status.

• A comprehensive summary of antibiotic usage and microbiology to date! (The ones relevant to the current clinical context.)
• A discussion with your surgical registrar about the operative findings and concerns.
• A comprehensive exposure history.
• Knowing the exact question being asked.

• MRSA, VRE or MRGN on a screening swab does not indicate infection.
• Positive wound swabs and urine cultures do not always require treatment, the clinical context is important (blood cultures do not fall in this category).
• Vancomycin dosing/withholding doses, etc.
  • Charting vancomycin after the phlebotomist (e.g. dose at 11am and 11pm) may be easier if you would like the morning phlebotomist to collect your trough vancomycin level and you do not want to be left confused about what happened first – the blood test or the dose of antibiotic.
  • If in doubt we are always happy to advise what to do with vancomycin or other drugs.