Hallarsis, Bienvinido G.

HRN: 03-89-68  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/08/2023
CEFTRIAXONE 1G (VIAL)
10/08/2023
10/14/2023
IV
2g
OD
COPD In AE CAP MR
Checking Final Appropriateness 
10/08/2023
LEVOFLOXACIN 500MG (TAB)
10/08/2023
10/14/2023
PO
500mg
OD
COPD In AE CAP MR
Checking Final Appropriateness 
10/09/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/09/2023
10/15/2023
IVTT
4.5g
Q8
Cap HR
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: