OET letter for a patient with an infection: antibiotics, isolation and wound or line care
In an OET Nursing letter about a patient with an infection, name the infection and where it is, say how the patient has responded, and state the antibiotic the reader must continue with drug, dose, route and the end date or number of days left. If the notes mention a resistant organism, isolation precautions or a line or wound that needs care, put that in a clear sentence, because the receiving team must act on it from the day the patient arrives.
What the reader must know about an infection
Infection case notes often include temperature charts, culture results, antibiotic changes, blood tests and isolation instructions. The reader, whether a GP, a community nurse, a hospital-in-the-home team or a residential facility, has four practical questions:
- What infection, and where? (for example, cellulitis of the left leg, a urinary tract infection, an infected wound)
- Is it getting better?
- What treatment continues, and until when?
- Is there a risk to others or a device to manage? (resistant organism, isolation, cannula, catheter, wound)
If your letter answers those four questions clearly, most of the temperature chart and the earlier antibiotic changes can be left out.
What to include and what to leave out
| Usually include | Usually leave out |
|---|---|
| Infection type and site | Every temperature recording |
| Response to treatment, as a trend | Full blood count and every inflammatory marker value |
| Current antibiotic: drug, dose, route, frequency | Antibiotics that were changed days ago, unless the change matters (for example, an allergy reaction) |
| End date or days remaining | Culture results that changed nothing |
| Allergy or reaction to an antibiotic | Hospital cleaning or isolation routine details |
| Resistant organism and precautions required | Detailed ward movements |
| Lines, catheters or wounds and their care or removal | Unrelated past history |
| Results to recheck, if the notes ask | |
| Signs that should prompt review, if the notes list them |
Turning infection notes into sentences
| Notes | Letter sentence |
|---|---|
| Cellulitis L lower leg, erythema ↓ 50% | "The redness from his left lower-leg cellulitis has reduced by about half." |
| Afebrile 48 h | "He has had no fever for the last 48 hours." |
| IV flucloxacillin → PO cefalexin 500 mg QID, 5 days left | "His antibiotics have been changed from intravenous to oral cefalexin 500 mg four times a day, with five days remaining." |
| Rash with amoxicillin 2019 | "He developed a rash with amoxicillin in 2019." |
| MRSA +ve nasal swab, contact precautions | "A nasal swab was positive for MRSA, so contact precautions are required." |
| IDC removed 10/8, voiding well | "His urinary catheter was removed on 10 August, and he is passing urine normally." |
Copy organism names, antibiotic names, doses and dates exactly. For allergy wording and medicine layout, see medications in OET letters; for dressings, see wound care letters.
Where to put infection-control information
A resistant organism or isolation requirement is not background detail. Put it either:
- in the paragraph about the patient's current condition, in its own sentence; or
- in the request, if the reader must arrange something such as a single room.
Do not hide it at the end of a long sentence about blood results. A transfer to a residential facility in particular needs it early enough to prepare. See aged care transfer letters for that setting.
Worked example (invented case)
Case summary (invented): Mr Daniel Okafor, 74, lives in a residential care facility; has type 2 diabetes, mild dementia. Admitted 5 August with cellulitis of left lower leg; temperature 38.6 °C on admission. IV flucloxacillin 5–8 August; then oral cefalexin 500 mg four times a day, started 9 August, 7-day course (ends 15 August). Known rash with amoxicillin (2019). Redness reduced by about half; no fever for 48 hours. Nasal swab positive for MRSA on 6 August; contact precautions in hospital. Peripheral cannula removed 9 August. Leg to be elevated when sitting. Blood glucose higher during infection, now back to usual range. Enjoys card games. Returning to facility 10 August. Task: write to the nurse manager of the facility.
Selection decisions:
- In: infection and site, response, current oral antibiotic and end date, amoxicillin rash, MRSA and precautions, leg elevation, glucose briefly raised (diabetes is relevant to infection risk).
- Out: temperature on admission, the IV course detail beyond one clause, removed cannula, card games.
Sample letter body:
Dear Nurse Manager,
Re: Mr Daniel Okafor, aged 74
I am writing to inform you that Mr Okafor is returning to your facility today following treatment for cellulitis of his left lower leg, and to advise you of his ongoing care.
Mr Okafor was admitted on 5 August and initially received intravenous antibiotics. The redness in his leg has reduced by about half, and he has had no fever for the last 48 hours. He is now taking oral cefalexin 500 mg four times a day, which should continue until 15 August. Please note that he developed a rash with amoxicillin in 2019.
A nasal swab taken on 6 August was positive for methicillin-resistant Staphylococcus aureus (MRSA), so contact precautions will be required. His blood glucose was higher during the infection but has now returned to his usual range.
I would be grateful if you could ensure he completes his antibiotic course, keep his leg elevated when he is sitting, and arrange contact precautions. Please contact the ward if the redness spreads or he develops a fever.
Yours sincerely,
Note the specific end date, the allergy in a sentence of its own, and the MRSA status placed before the request so the reader can act on it.
Practise a full case under timed conditions at /writing/, or check your letter for an estimated mark on each criterion.
Mistakes to avoid
- No end date for antibiotics. Always give the date or days remaining.
- Burying a resistant organism. Give it its own sentence.
- Listing every result. Summarise the trend.
- Forgetting allergies. An antibiotic reaction is essential information.
- Unexplained abbreviations. Write MRSA, PICC and similar terms in full on first use. See the abbreviations guide.
Related: discharge and transfer letters, diabetes patient letters and selecting case notes.
Sources
This guide is medEmu's writing advice, not official OET guidance or clinical advice; all patients, organisms, medicines, doses and dates are invented for practice and must not be used to guide care. The network used for this run could not reach oet.com, so no OET test facts are stated beyond the criterion names. For OET's official Writing information, see oet.com.