ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAP
1
TimestampDate ID MonthالمناطقHospitals DatePatient file number WardAgePediatrics/Adults GenderIndication for antibiotics If it's guided by culture, please add the name of microorganismDiagnosis Microbiology specimens requested
Is antibiotic treatment prescribed according to MOH guideline (Pneumonia, UTI, Cellulitis)?
ANTIBIOTIC/SDOSE:
For group A & B ONLY, The restricted antibiotic is dispensed after ASP member approval:
Appropriate regimen (Initial drug, dose, rout and duration) ?Appropriate therapy management (Escalation, De-escalation, TDM, IV to oral .... etc) Asp team interventions [De-escalation of the therapy]Asp team interventions [Escalation of the therapy]Asp team interventions [Dose corrected or adjusted]Asp team interventions [Change the Rout of administration (e.g: change from IV to PO)]Asp team interventions [Change the Duration]Asp team interventions [Change the frequency]Asp team interventions [Stop the antibiotic]Asp team interventions [Optimize the therapy]Asp team interventions [Therapeutic drug monitoring]Asp team interventions [Decide the management plan (choose the antibiotics or dose)]Asp team interventions [Request the culture]
Asp team interventions [Actions taken (e.g: dose adjustment or antibiotic change ..etc) to overcome the Drug-drug interaction]
Asp team interventions [Information deliver to nurse about medication administration]Asp team interventions [Continue the same (No intervention -appropriate regimen)]Asp team interventions [Request Lab ]Asp team interventions [Catheter Removal]Did the physician accept the intervention ?
If the patient on Vancomycin or Aminoglycoside only, is the physician requesting for TDM?
According to antibiotic level, Did the dose adjusted appropriately by physician Name and specialty of responsible person
12
1/5/2022 14:03:535 يناير 2022170Januaryالاحساءمستشفى الملك فيصل العام1/5/20220000000499NICU
Less than 1 year
Pediatrics FemaleEmpiricSepsisYesThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Ampicillin Sodium, Gentamicin Sulfate
AMPICILLIN 110 MG IV Q 8 HOURS and GENTAMICIN 9.9 MG IV Q 36 HOURS
YesNoNoNoNoNoNoYesNoYesYesYesYesNoYesNoYesYesKits not availableMossa AlSmail, Pharmacist
25
1/10/2022 14:42:5910 يناير 2022371Januaryالاحساءمستشفى الملك فيصل العام1/10/20221033392828Medical
45- 54 years
Adults FemaleEmpiricCommunity acquired pneumoniaNoYes
Azithromycin, Ceftriaxone Sodium
Not restricted antibioticNoYesNoNoYesNoYesNoNoNoNoNoNoNoNoNoNoYesNoNot adjustedAli AlYounis, PharmD
27
1/10/2022 14:54:5010 يناير 2022377Januaryالاحساءمستشفى الملك فيصل العام1/10/20221006167132Medical
35-44 years
Adults MaleEmpiricBone infectionNoThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Ceftriaxone Sodium, Vancomycin Hydrochloride
Not restricted antibioticYesYesNoYesYesNoNoNoNoYesNoYesNoNoNoNoYesYesRequested by pharmacist/clinical pharmacistAli AlYounis, PharmD
28
1/10/2022 15:09:4210 يناير 2022383Januaryالاحساءمستشفى الملك فيصل العام1/10/20221004343313ICU
55-65 years
Adults FemaleEmpiricFoot DiabeticYesThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)Ceftazidime, LinezolidNoNoNoNoYesNoNoNoNoNoNoNoNoNoNoNoNoYesNoNot adjustedAli AlYounis, PharmD
29
1/10/2022 15:14:5110 يناير 2022386Januaryالاحساءمستشفى الملك فيصل العام1/10/20221003813464ICU
More than 65 years
Adults FemaleEmpiricCOVID 19 with suspected pneumoniaYesYesCeftriaxone SodiumYesYesNoNoNoNoNoNoNoNoNoNoNoNoNoNoNoNo intervention was recommendedAli Alyounis, PharmD
30
1/10/2022 15:17:1810 يناير 2022388Januaryالاحساءمستشفى الملك فيصل العام1/10/20221020150189ICU
More than 65 years
Adults MaleGuided by cultureK.pneumoniae ESBL
Urinary tract infection, COVID 19 with suspected pneumonia
YesYesMeropenemYesYesNoNoYesNoNoNoNoNoNoNoNoNoNoNoNoYesAli Alyounis, PharmD
31
1/10/2022 15:21:3610 يناير 2022390Januaryالاحساءمستشفى الملك فيصل العام1/10/20221004256838ICU
More than 65 years
Adults FemaleGuided by cultureP. aeruginosaMDR
Hospital acquired pneumonia/Ventilator acquired pneumonia
YesYesCiprofloxacin400 mg IV BIDYesYesNoNoNoNoNoNoNoNoNoNoNoNoNoYesNoNo intervention was recommendedAli AlYounis,PharmD
32
1/11/2022 14:40:2711 يناير 2022440Januaryالاحساءمستشفى الملك فيصل العام1/11/20221138088719Medical
1- 17 years
Pediatrics MaleEmpiricAbdominal infectionNoNo
Ceftriaxone Sodium, Metronidazole
NoYesYesNoNoYesNoNoNoNoNoNoNoNoNoNoNoYesNoAli AlYounis, PharmD
33
1/11/2022 14:43:4211 يناير 2022441Januaryالاحساءمستشفى الملك فيصل العام1/11/20221001601804Medical
55-65 years
Adults MaleEmpiricNot- infectious diseaseYesNo
Piperacillin Sodium/Tazobactam Sodium
NoNoNoNoNoNoNoNoYesNoNoNoNoNoNoNoNoNoAli AlYounis, Pharmd
63
1/17/2022 15:04:1917 يناير 2022795Januaryالاحساءمستشفى الملك فيصل العام1/16/20221006167132Medical
35-44 years
Adults MaleEmpiricBone infectionNoThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Ceftriaxone Sodium, Vancomycin Hydrochloride
YesYesNoNoYesNoNoNoNoYesYesYesNoNoNoNoYesYesRequested by pharmacist/clinical pharmacistAdjusted by pharmacist/clinical pharmacistAli Alyounis, PharmD
64
1/17/2022 15:06:2617 يناير 2022796Januaryالاحساءمستشفى الملك فيصل العام1/16/20221020150189Medical
More than 65 years
Adults MaleGuided by cultureESBL (K.Pneumoniae)Urinary tract infectionYesYesMeropenemYesYesNoNoNoNoNoNoYesNoNoNoNoNoNoNoNoYesAli AlYounis, PharmD
65
1/17/2022 15:09:0917 يناير 2022797Januaryالاحساءمستشفى الملك فيصل العام1/12/20221004343313ICU
55-65 years
Adults FemaleEmpiricSepsisYesThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Linezolid, Piperacillin Sodium/Tazobactam Sodium
YesYesNoYesYesNoNoYesNoYesNoNoYesNoNoNoNoYesNoAli Alyounis, PharmD
66
1/17/2022 15:11:2217 يناير 2022798Januaryالاحساءمستشفى الملك فيصل العام1/12/20221016464354ICU
More than 65 years
Adults MaleEmpiricSepsisYesThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Meropenem, Vancomycin Hydrochloride
YesYesNoNoYesNoNoNoNoNoYesNoNoNoNoNoNoYesRequested by pharmacist/clinical pharmacistAdjusted by pharmacist/clinical pharmacistAli AlYounis, PharmD
67
1/18/2022 8:07:1718 يناير 2022813Januaryالاحساءمستشفى الملك فيصل العام1/16/20221003094560Medical
45- 54 years
Adults FemaleEmpiricCOVID 19 with suspected pneumoniaNoYes
Azithromycin, Cefuroxime Axetil
YesYesNoNoNoYesYesNoNoNoNoNoNoNoNoNoNoYesNoAli AlYounis, PharmD
68
1/18/2022 8:10:3518 يناير 2022814Januaryالاحساءمستشفى الملك فيصل العام1/17/20221006167132Medical
35-44 years
Adults MaleEmpiricBone infectionNoThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Ceftriaxone Sodium, Vancomycin Hydrochloride
YesYesNoNoYesNoNoNoNoNoYesNoNoNoNoNoYesYesRequested by pharmacist/clinical pharmacistAdjusted by pharmacist/clinical pharmacistAli AlYounis,PharmD
69
1/18/2022 8:13:2918 يناير 2022815Januaryالاحساءمستشفى الملك فيصل العام1/17/20221005931264Medical
More than 65 years
Adults MaleEmpiricCommunity acquired pneumonia, Urinary tract infectionYesYes
Azithromycin, Ceftriaxone Sodium
YesYesNoNoNoNoNoNoNoNoNoNoNoNoNoYesNoNo intervention was recommendedNoAli AlYounis, PharmD
70
1/18/2022 8:16:0818 يناير 2022816Januaryالاحساءمستشفى الملك فيصل العام1/17/20221004257596Medical
55-65 years
Adults MaleEmpiricNot- infectious diseaseNoNo
Amoxicillin/Clavulanate Potassium
NoNoNoNoNoNoNoNoYesNoNoNoNoNoNoNoNoNoNoAli AlYounis, PharmD
71
1/18/2022 8:18:0718 يناير 2022817Januaryالاحساءمستشفى الملك فيصل العام1/17/20221017357425Medical
55-65 years
Adults FemaleEmpiricCOVID 19 with suspected pneumoniaYesYes
Azithromycin, Ceftriaxone Sodium
YesYesNoNoNoNoNoNoNoNoNoNoNoNoNoYesNoNo intervention was recommendedNoAli AlYounis, PharmD
72
1/19/2022 7:44:4719 يناير 2022874Januaryالاحساءمستشفى الملك فيصل العام1/18/20221004343313ICU
55-65 years
Adults FemaleEmpiric
culture availabbe K. pneumoniae MDR waiting for colistin sensitivity, Micro lab cannt identify mechanism of resistance
Blood stream infection, Septic shock, SepsisYesThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Linezolid, Piperacillin Sodium/Tazobactam Sodium
YesYesNoNoYesNoNoNoNoNoNoNoYesNoNoNoNoYesNoAli Alyounis, PharmD
73
1/19/2022 7:49:3719 يناير 2022875Januaryالاحساءمستشفى الملك فيصل العام1/18/20221015348194ICU
More than 65 years
Adults FemaleEmpiricCOVID 19 with suspected pneumoniaYesYes
Azithromycin, Piperacillin Sodium/Tazobactam Sodium
YesYesNoNoNoYesNoNoNoNoNoNoNoNoNoNoNoYesAli AlYounis, PharmD
74
1/19/2022 7:55:4019 يناير 2022876Januaryالاحساءمستشفى الملك فيصل العام1/18/20221004257596Medical
55-65 years
Adults MaleEmpiricNot- infectious diseaseNoNo
Amoxicillin/Clavulanate Potassium
NoNoNoNoNoNoNoNoYesNoNoNoNoNoNoNoNoYesAli AlYounis, PharmD
98
1/25/2022 8:42:4425 يناير 20221351Januaryالاحساءمستشفى الملك فيصل العام1/19/20221002086526Medical
More than 65 years
Adults FemaleEmpiricCommunity acquired pneumoniaNoYesLevofloxacinYesYesNoYesNoNoNoNoNoNoNoNoNoNoNoNoNoYesAli AlYounis, PharmD
99
1/25/2022 8:47:2025 يناير 20221352Januaryالاحساءمستشفى الملك فيصل العام1/19/20221109711521Medical
18-24 years
Adults FemaleEmpiricBone infectionNoThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Ceftriaxone Sodium, Vancomycin Hydrochloride
YesYesNoNoNoNoNoNoNoNoYesNoNoNoNoNoNoYesRequested by pharmacist/clinical pharmacistAli AlYounis, PharmD
155
1/31/2022 8:21:5831 يناير 20221914Januaryالاحساءمستشفى الملك فيصل العام1/23/20221028655957Medical
More than 65 years
Adults MaleEmpiricCommunity acquired pneumoniaNoYes
Azithromycin, Ceftriaxone Sodium
YesYesNoNoNoNoNoNoNoNoNoNoNoNoNoYesNoNo intervention was recommendedNoAli AlYounis, PharmD
156
1/31/2022 8:26:1631 يناير 20221915Januaryالاحساءمستشفى الملك فيصل العام1/23/20221006499519Medical
55-65 years
Adults FemaleEmpiricUpper respiratory tract infectionNoThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Meropenem, Metronidazole
NoNoYesNoNoNoNoNoNoNoNoNoNoNoNoNoNoNoNoNot adjustedAli AlYounis, PharmD
157
1/31/2022 8:29:2031 يناير 20221916Januaryالاحساءمستشفى الملك فيصل العام1/23/20221109711521Medical
18-24 years
Adults FemaleEmpiricBone infectionNoThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Ceftriaxone Sodium, Vancomycin Hydrochloride
YesYesNoNoYesNoNoYesNoNoYesNoNoNoNoNoNoYesRequested by pharmacist/clinical pharmacistAdjusted by pharmacist/clinical pharmacistAli AlYounis, PharmD
158
1/31/2022 8:35:2331 يناير 20221919Januaryالاحساءمستشفى الملك فيصل العام1/23/20221005931264Medical
More than 65 years
Adults MaleEmpiricUrinary tract infectionYesYesMeropenemYesYesYesNoNoNoNoNoNoNoNoNoNoNoNoNoNoYesNoAli AlYounis, PharmD
159
1/31/2022 8:40:0231 يناير 20221920Januaryالاحساءمستشفى الملك فيصل العام1/24/20221004343313ICU
55-65 years
Adults FemaleEmpiricBlood stream infectionYesThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Piperacillin Sodium/Tazobactam Sodium
YesYesNoNoYesNoNoNoNoNoNoNoNoNoNoNoNoYesNoAli AlYounis, PharmD
160
1/31/2022 8:45:2431 يناير 20221921Januaryالاحساءمستشفى الملك فيصل العام1/26/20221000757540Medical
45- 54 years
Adults FemaleEmpiricCommunity acquired pneumoniaNoYesCefuroxime AxetilYesYesNoNoNoYesYesNoNoNoNoNoNoNoNoNoNoYesNoAli AlYounis, PharmD
161
1/31/2022 8:49:0431 يناير 20221922Januaryالاحساءمستشفى الملك فيصل العام1/27/20221083266161ICU
25-34 years
Adults FemaleEmpiricNot- infectious diseaseNoNoMeropenemNoYesNoNoNoNoNoNoYesNoNoNoNoNoNoNoNoYesNoAli ALYounis, PharmD
162
1/31/2022 8:51:5431 يناير 20221923Januaryالاحساءمستشفى الملك فيصل العام1/27/20221057324053ICU
45- 54 years
Adults MaleEmpiricNot- infectious diseaseYesThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)MeropenemNoYesNoNoNoNoNoNoYesNoNoNoNoNoNoNoNoYesNoAli AlYOunis, PharmD
163
1/31/2022 13:58:5931 يناير 20222053Januaryالاحساءمستشفى الملك فيصل العام1/31/20221001635869Medical
More than 65 years
Adults MaleEmpiricNot- infectious diseaseNoThe patient's diagnosis rather than (Pneumonia, UTI, Cellulitis)
Piperacillin Sodium/Tazobactam Sodium
NoNoNoNoNoNoNoNoYesNoNoNoNoNoNoNoNoYesNoAli AlYounis, PharmD
164
1/31/2022 14:01:2731 يناير 20222057Januaryالاحساءمستشفى الملك فيصل العام1/31/20221030529505Medical
More than 65 years
Adults MaleEmpiricCOVID 19 with suspected pneumoniaNoYesCefuroxime AxetilYesYesNoNoNoYesNoNoNoNoNoNoNoNoNoNoNoYesNoAli AlYounis, PharmD