Verallo, Rolando G.

HRN: 01-02-26  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/22/2023
CEFTRIAXONE 1G (VIAL)
09/22/2023
09/29/2023
IV
2gms
OD
CAP MR
Checking Final Appropriateness 
09/22/2023
AZITHROMYCIN 500MG TABLET (TAB)
09/22/2023
09/27/2023
PO
500mg
OD
CAP MR
Checking Final Appropriateness 
10/09/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/09/2023
10/15/2023
IV
1.5
Q6
Covid Pneumonia
Checking Final Appropriateness 
10/09/2023
CLARITHROMYCIN 500MG (CAP)
10/09/2023
10/15/2023
PO
1 Tab
BID
Covid Pneumonia
Checking Final Appropriateness 
10/19/2023
LEVOFLOXACIN 500MG (TAB)
10/19/2023
10/23/2023
PO
500MG
OD
Covid Pneumonia
Checking Final Appropriateness 
10/19/2023
LEVOFLOXACIN 500MG (TAB)
10/19/2023
10/23/2023
PO
500MG
OD
Covid 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: