Prescription Writing Practice

First episode of Clostridioides difficile infection after co-amoxiclav

Write a prescription for clostridioides difficile infection (first episode) and have every line marked: drug choice, dose, route, frequency and duration, checked against the patient's allergies, current medicines, renal function and the interaction database, with each error explained.

medium8 scoring rules

Patient
72 years, female, 65 kg
Diagnosis
Clostridioides difficile infection (first episode)
Allergies
None known
Current medicines
atorvastatin 20 mg once daily; ramipril 5 mg once daily; omeprazole 40 mg once daily; amoxicillin/clavulanate intravenous

The scenario

Patient C-104 is a 72-year-old woman admitted to an acute medical ward for intravenous co-amoxiclav for community-acquired pneumonia. On day 5 of her course, she develops profuse watery diarrhoea, six to eight stools per day, with mild lower abdominal cramping. On examination, temperature 38.2°C, pulse 102 bpm, blood pressure 110/68 mmHg, respiratory rate 18/min, oxygen saturation 96% on room air. Abdomen is soft with lower abdominal tenderness, no guarding. Stool sample is positive for Clostridioides difficile toxin. White cell count is 14.2 × 10⁹/L, C-reactive protein 86 mg/L. She has no known drug allergies. Her regular medicines are atorvastatin 20 mg once daily and ramipril 5 mg once daily. In addition to co-amoxiclav, she is on omeprazole 40 mg once daily for gastro-oesophageal reflux. Weight 65 kg. She is not pregnant. Write the prescription for the C. difficile infection, including any changes to her current antimicrobial therapy.

What gets marked

  • Whether you chose an indicated drug, and whether you avoided the contraindicated ones.
  • Dose, route, frequency and duration against the range for this patient.
  • Renal and hepatic dose adjustment where this patient's numbers demand it.
  • Allergy cross-reactivity and interactions with the medicines already on the chart.
  • The instructions and monitoring you write, not only the drug you pick.

8 scoring rules apply to this scenario. A single critical error fails the attempt whatever the score.

Log in to prescribe for "First episode of Clostridioides difficile infection after co-amoxiclav"

A free account opens the prescription pad: search the formulary, write the chart, and have it marked line by line by the safety engine.

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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.