Sanchez, Xhiandrea A.

HRN: 24-18-42  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/30/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
11/30/2023
12/06/2023
IV
1200mg
Q6h
T/c Sepsis
Checking Final Appropriateness 
11/30/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
11/30/2023
12/06/2023
IV
70mg
Q8h
T/c Sepsis
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: