Mohammad, Mansul A.

HRN: 07-43-21  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/04/2024
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
04/04/2024
04/10/2024
IVTT
2.25 G
Q8
Cap HR
Checking Final Appropriateness 
04/04/2024
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
04/04/2024
04/10/2024
IVTT
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: