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.
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.
Helpful Resources
eTG is an excellent resource.
The microbiology registrar is an excellent and often very helpful resource, and often they even solve the problem for you. In particular, they can help with oral options.
UptoDate is always useful in any clinical context.
Hospital guidelines.
You can also discuss with your ward pharmacist, they are very helpful.
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