Albarico, Phoebe O.

HRN: 17-13-75  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/04/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/04/2023
05/12/2023
IV
1.5gm
TID
Pneumonia
Waiting Final Action 
05/05/2023
AZITHROMYCIN 500MG TABLET (TAB)
05/05/2023
05/10/2023
NGT
500mg
OD
CAP-HR
Waiting Final Action 
05/05/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
05/05/2023
05/12/2023
IV
2.25grams
Q8H
CAP-HR
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: