Basio, Jonathan .

HRN: 23-52-29  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/10/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/10/2023
08/16/2023
IVT
4.5 Mg
Q6
Cap Mr, COPD In Ae , Cor Pulmonale
Checking Final Appropriateness 
08/10/2023
AZITHROMYCIN 500MG TABLET (TAB)
08/10/2023
08/12/2023
PO
500mg
OD
Cap MR COPD In Ae , Cor Pulmonale
Checking Final Appropriateness 
08/11/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
08/11/2023
08/17/2023
IV
1.5 Grams IV
Q6
Pneumonia
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: