Perolino, Meljean O.

HRN: 23-36-81  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/23/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/23/2023
07/29/2023
IV
50
Q24
Pcap D
Waiting Final Action 
07/23/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/23/2023
07/29/2023
IV
50
Q24
Pcap D
Waiting Final Action 
07/23/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
07/23/2023
07/29/2023
IV
450
Q8
PcapD
Waiting Final Action 
07/24/2023
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
07/24/2023
07/30/2023
IVTT
1.2ml
Q24h
PCAP D
Waiting Final Action 
07/29/2023
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
07/29/2023
08/05/2023
PO
1.5ml
Q12h
PCAP D
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: