Balar, Agustin .

HRN: 09-17-34  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/07/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/07/2024
02/07/2024
IV
4.5 G LD
Now
CAP HR
Checking Final Appropriateness 
02/07/2024
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
02/07/2024
02/13/2024
IV
2.5 G
Q8
CAP HR
Checking Final Appropriateness 
02/07/2024
AZITHROMYCIN 500MG TABLET (TAB)
02/07/2024
02/11/2024
PER NGT
500 Mg
OD
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: