PEBC Part I (MCQ) · Competency 1A Clinical Care (about 50% of Part I)
Infectious Diseases & Immunization
Infection items test first-line antibiotic choice by site and patient, stewardship (when not to treat), key interactions and adverse effects, STI treatment and the Canadian Immunization Guide, using AMMI Canada, Bugs & Drugs, PHAC and NACI sources.
1A Clinical Care·2 min read·7 sections
✓Checked against the AMMI Canada guidance; Bugs & Drugs (AHS); PHAC Canadian Guidelines on STI (gonorrhea updated 4 Jun 2026); Canadian Immunization Guide and NACI statements (2024-2025); Health Canada product monographs; checked 13 Oct 2026. Not affiliated with or endorsed by The Pharmacy Examining Board of Canada (PEBC).
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Must-know for the exam
✓Uncomplicated cystitis: nitrofurantoin 5 days, TMP-SMX 3 days (if resistance allows) or fosfomycin 3 g once; avoid fluoroquinolones.
✓Do not treat asymptomatic bacteriuria except in pregnancy and before certain urologic procedures.
✓Nitrofurantoin and fosfomycin do not treat pyelonephritis.
✓First C. difficile episode: oral vancomycin 125 mg four times daily or fidaxomicin; never IV vancomycin.
✓H. pylori: 14-day quadruple therapy (bismuth or concomitant) per the Toronto consensus.
✓Gonorrhea: ceftriaxone 500 mg IM once, treat chlamydia if not excluded, test of cure (NAAT at 3-4 weeks).
✓Chlamydia: doxycycline 100 mg twice daily for 7 days preferred; early syphilis: benzathine penicillin G 2.4 MU IM once.
✓Recombinant zoster vaccine: 2 doses 2-6 months apart for adults 50+, including after shingles.
✓Tdap in every pregnancy, ideally at 27-32 weeks; live vaccines are avoided in pregnancy and immunosuppression.
✓Vaccine cold chain excursion: quarantine at 2-8 °C and call public health before using or discarding.
▸On this page · 7 sections
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Traps that cost marks
→Using a fluoroquinolone for simple cystitis.
→Treating pyelonephritis with a cystitis-only antibiotic.
→Not treating asymptomatic bacteriuria in pregnancy.
→Treating a positive culture rather than a symptomatic patient.
→Using a respiratory fluoroquinolone for low-risk pneumonia.
→Defaulting to a macrolide for strep throat in a non-allergic patient.
→Treating 4 days of discoloured discharge as bacterial sinusitis.
→Choosing an agent with poor streptococcal coverage for non-purulent cellulitis.
How this is tested on Part I
Items combine a patient (age, pregnancy, kidney function, allergies, interacting drugs) with an infection and ask for the best agent, duration or safety check.
Respiratory and ENT
Low-risk CAP: amoxicillin 1 g three times daily; comorbidities or recent antibiotics: broader regimens.
Strep pharyngitis: penicillin V or amoxicillin for 10 days.
Acute sinusitis: mostly viral; antibiotics if symptoms persist beyond 7-10 days or worsen.
AOM: watchful waiting is reasonable for well children 6 months+ with follow-up.
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Educational practice material for exam preparation only. Not medical advice and not a substitute for current product monographs, clinical guidelines or professional judgement. Questions have not yet been reviewed by a licensed pharmacist.
