Sumpatan, Evelyn D.

HRN: 08-18-65  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/10/2023
CEFTRIAXONE 1G (VIAL)
12/10/2023
12/17/2023
IV
2g
Q24
Cap Mr
Waiting Final Action 
12/10/2023
AZITHROMYCIN 500MG TABLET (TAB)
12/10/2023
12/14/2023
PO
500mg
OD
CAP MR
Waiting Final Action 
12/12/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/12/2023
12/19/2023
IV
4.5g
Q8
CAP MR
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: