PPhantomAI

Mrs. C.O

PID-20142

29 yrs · Female · 71 kg · 165 cm · Antenatal Ward

Diagnosis
Urinary tract infection, pregnancy (28 weeks gestation)
Vitals
BP118/74 mmHgNormalBlood PressureReference90–120 / 60–80 mmHgActual118/74 mmHg
HR88 bpmNormalHeart RateReference60–100 bpmActual88 bpm
RR16/minNormalRespiratory RateReference12–20 breaths/minActual16/min
TEMP37.5°CElevatedTemperatureReference36.1–37.2°CActual37.5°C
SPO299%NormalOxygen SaturationReference≥ 95%Actual99%
Labs
Serum Creatinine0.6 mg/dLNormalSerum CreatinineReference0.5–1.3 mg/dLActual0.6 mg/dL
Creatinine Clearance110 mL/minNormalCreatinine ClearanceReference≥ 50 mL/min (normal/mild impairment)Actual110 mL/min
eGFR>90 mL/min/1.73m²NormaleGFRReference≥ 60 mL/min/1.73m²Actual>90 mL/min/1.73m²
Liver FunctionWithin normal limitsNormalLiver FunctionReferenceWithin normal limitsActualWithin normal limits
Blood Glucose5.2 mmol/LNormalBlood GlucoseReference4.0–7.8 mmol/LActual5.2 mmol/L
Allergies & Status
No known drug allergies (NKDA)
Pregnant — 28 weeks gestation
Clinical Notes
Presented with dysuria and suprapubic discomfort. Urine culture pending. Prescribed ciprofloxacin at the walk-in clinic without pregnancy status being flagged in the system.

Current Medications

  • Prenatal multivitamin
  • Ferrous sulfate 200 mg once daily

New Prescriptions — Pending Dispense

Ciprofloxacin 500 mg
Oral, Twice daily for 7 days
Unit: 88 Central: 420 Auto-Reorder Triggered
Urine Dipstick Strips Box of 25Consumable
For follow-up urinalysis
Clinical AI Analysis
0%Risk Score
0%AI Confidence
HighPriority Level

Medication Interactions

Ciprofloxacin + Pregnancy (28 weeks)Major

Fluoroquinolones are generally avoided in pregnancy due to animal studies showing arthropathy (cartilage damage) risk in the developing fetus. Safer, well-studied alternatives exist for uncomplicated UTI in pregnancy.

→ Do not dispense. Recommend a pregnancy-appropriate first-line agent and flag pregnancy status clearly in the patient record.

Alternatives for Ciprofloxacin
Nitrofurantoin 100mg — Oral, Twice daily for 5 days
Minimal interaction with warfarin; appropriate for uncomplicated UTI if CrCl ≥30 mL/min.
Fosfomycin 3g — Oral, Single dose
No significant warfarin interaction; simple single-dose regimen.

Alternatives

Nitrofurantoin 100 mg twice daily for 5-7 days (first-line in pregnancy, avoid only near term at 36+ weeks)
Cephalexin 500 mg twice daily for 5-7 days (safe in pregnancy)

Counselling Points

This particular antibiotic is not recommended during pregnancy
A safer alternative will be provided that treats the infection just as effectively
Complete the full course and attend follow-up antenatal appointments
Do Not Dispense

Ciprofloxacin carries a well-established caution in pregnancy. Given safe, effective first-line alternatives exist for uncomplicated UTI in pregnancy, this prescription should be corrected with the prescriber rather than dispensed as written.

Duplicate Prescription Check

No duplicate or overlapping therapy detected.

Dose Accuracy Check

Ciprofloxacin 500 mg — Within the typical adult range of 250-750mg per dose.

Interaction Cross-Check

Every unique pair across current medications and new prescriptions — not just new-vs-current.

Prenatal + FerrousLow
Prenatal + CiprofloxacinNew RxLow
Ferrous + CiprofloxacinNew RxLow

Renal Function & Dosing

110NormalCreatinine ClearanceReference≥ 50 mL/min (normal/mild impairment)Actual110mL/min
Cockcroft-Gault recalculation: 155.1 mL/min
Normal / Mild Impairment

No medications on this chart require renal dose banding from the reference table.

Acid-Base Disturbance Profile

Low
pH
7.44NormalpHReference7.35–7.45Actual7.44
pCO₂
30 mmHgLowpCO₂Reference35–45 mmHgActual30 mmHg
HCO₃⁻
21 mEq/LLowHCO₃⁻Reference22–26 mEq/LActual21 mEq/L
Lactate
0.9 mmol/LNormalLactateReference< 2 mmol/LActual0.9 mmol/L
Fully Compensated Metabolic AcidosisFully Compensated

pH has been normalised, but both pCO2 and HCO3 are low — consistent with a metabolic acidosis that respiratory compensation has fully corrected for.

→ Consistent with the normal respiratory alkalosis of pregnancy (progesterone-driven increase in minute ventilation).

How This Affects the Treatment Plan — Suggested Interventions

Identify and treat the underlying cause (renal failure, DKA, lactic acidosis, toxin ingestion) rather than treating the pH number in isolation.
Recheck the metabolic panel and repeat the blood gas after any intervention to confirm the trend is genuinely improving.

Theatre

No theatre procedure currently scheduled for this patient.

Unit vs Central Stock — This Patient's Medications

AMC, ROL, and months-of-stock (MOS) at both the unit and central store, with a recommendation for each.

Prenatal
Unit StockAdequate
340
Stock
197
AMC
1.7
MOS

Stock within normal range (~1.7 months of stock) — no action needed.

Central StoreAdequate
1400
Stock
1180
AMC
1.2
MOS

Stock within normal range (~1.2 months of stock) — no action needed.

Ferrous
Unit StockAdequate
560
Stock
293
AMC
1.9
MOS

Stock within normal range (~1.9 months of stock) — no action needed.

Central StoreAdequate
2600
Stock
1900
AMC
1.4
MOS

Stock within normal range (~1.4 months of stock) — no action needed.

Ciprofloxacin
Unit StockBelow Reorder Level
88
Stock
150
AMC
0.6
MOS

Order 312 units to reach max stock level before it runs out (~0.6 months of stock remain).

Central StoreBelow Reorder Level
420
Stock
890
AMC
0.5
MOS

Order 1980 units to reach max stock level before it runs out (~0.5 months of stock remain).

Send Requisition to Bulk Store