Culture readiness
Summarize source, collection date/time, organism, susceptibilities, number of positive bottles/specimens, repeat cultures, and whether cultures were drawn before antibiotics.
ID consult triage
Should I Consult Infectious Disease?
A concise triage aid for antimicrobial strategy, diagnostic workup, source control, isolation, duration, OPAT, and immunocompromised infection questions.
Common ID questions
Frame the Infection Question
Before you consult
Make the ID Question Answerable
Source-control readiness
Clarify suspected source, drainable collection, infected hardware or line, obstruction, abscess, imaging, and which service owns source-control decisions.
Antibiotic timeline
Include current antibiotics and start dates, prior antibiotics this episode, allergy constraints, renal/hepatic function, fever curve, WBC trend, hemodynamics, and clinical response.
Stewardship framing
For bacteriuria, routine fever, uncomplicated cellulitis, or duration questions, define the syndrome and missing decision before asking ID to choose antimicrobials or duration.
Copyable consult message
ID Consult Dotphrase
Reason for Consult: *** Syndrome / suspected source: *** Cultures: source/date/organism/susceptibilities/repeats *** Current antibiotics and start dates: *** Prior antibiotics this episode: *** Source control completed/pending: *** Hardware / lines / prosthetic material: *** Immune status: *** Renal/hepatic function: *** Key imaging: *** Clinical question: *** Callback: *** Thank you!
Best practices for ID consults
- Lead with the syndrome, suspected source, culture timeline, and the decision ID can change.
- Separate antimicrobial strategy from source control; surgery, IR, urology, ENT, ortho, or line removal may need to be first or concurrent.
- For duration questions, include culture data, source control, clinical response, and local pathway context.
- Avoid asking for antibiotic choice or duration before the syndrome, cultures, source control, and response are defined.
ID consult patterns
High-Yield ID Context
Bacteremia or fungemia
S. aureus bacteremia, persistent bacteremia, fungemia, endocarditis concern, unclear source, or infected hardware often changes workup and source-control planning.
Deep-seated infection
CNS infection, epidural abscess, vertebral osteomyelitis, septic arthritis, prosthetic joint infection, or hardware infection can change diagnostic and treatment pathways.
High-risk host
Transplant, neutropenia, advanced immunosuppression, or rapidly worsening unclear infection raises the value of earlier ID discussion.
Stewardship constraint
Resistant organism, severe drug allergy constraint, OPAT feasibility, or high-consequence exposure can make ID input higher yield.
ID consults FAQ
Common ID Questions
Does every fever need ID?
No. A stable single fever without syndrome, cultures, imaging, exam focus, or initial workup is usually lower yield. ID discussion becomes more useful when the syndrome, source, host risk, cultures, or source-control question is defined.
When is source control the first issue?
Drainable collections, infected lines, obstruction, abscess, necrotizing concern, infected hardware, or operative/IR targets often need source-control ownership clarified before antimicrobial questions can be answered well.
What makes an antibiotic duration question answerable?
Culture data, diagnosis/syndrome, source control, clinical response, hardware, immune status, and local pathway context. Without those, duration is often premature.
References
Educational tool only. SIC provides clinician-facing educational consult-triage references. SIC does not diagnose, treat, prevent, cure, or mitigate disease and is not a substitute for clinical judgment, local guidelines, institutional referral pathways, antimicrobial stewardship recommendations, infection prevention policies, or recommendations from your infectious disease department. See disclaimer and how SIC works.