Valeriano, Jeric A.

HRN: 20-74-13  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/30/2023
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
09/30/2023
10/06/2023
PO
5ml
TID
Oral Candidiasis
Checking Final Appropriateness 
10/08/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/08/2023
10/15/2023
IV
4.5g
Q8H
Febrile Neutropenia
Checking Final Appropriateness 
10/09/2023
COTRIMOXAZOLE 960MG (TAB)
10/09/2023
10/15/2023
ORAL
800/160mg
2 Tabs TID
Oral Thrush, Immunocompromised State
Checking Final Appropriateness 
10/10/2023
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
10/10/2023
10/17/2023
PO
5
TID
Oral Candidiasis
Checking Final Appropriateness 
10/11/2023
FLUCONAZOLE 150MG (CAP)
10/11/2023
10/18/2023
PO
150mg
OD
Oral Thrush
Checking Final Appropriateness 
10/19/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/16/2023
10/22/2023
IV
4.5
Q6
Febrile Neutropenia
Checking Final Appropriateness 
10/22/2023
COTRIMOXAZOLE 960MG (TAB)
10/22/2023
10/29/2023
PO
960
OD
Febrike Neutropenia
Checking Final Appropriateness 
10/22/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/22/2023
10/28/2023
PO
500
OD
Febrile Neutropenia
Checking Final Appropriateness 
10/25/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/25/2023
10/31/2023
PO
500
MWF
Immunocompromised State; Prophylaxis
Checking Final Appropriateness 
10/25/2023
COTRIMOXAZOLE 960MG (TAB)
10/25/2023
10/31/2023
PO
960
OD
Immunocompromised State; Prophylaxis
Checking Final Appropriateness 
10/26/2023
FLUCONAZOLE 150MG (CAP)
10/26/2023
11/23/2023
PO
150mg
3x A Week
Candidiasis; Immunocompromised State
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: