Delos Santos, Gertrudes D.

HRN: 21-17-82  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/08/2024
CEFTRIAXONE 1G (VIAL)
04/08/2024
04/11/2024
IV
1gm
Q12
Cap Hr
Waiting Final Action 
04/08/2024
AZITHROMYCIN 500MG TABLET (TAB)
04/09/2024
04/09/2024
PER NGT
500mgtab
Q24
Cap Hr
Waiting Final Action 
04/09/2024
CEFTAZIDIME 1GM (VIAL)
04/09/2024
04/15/2024
IV
1 Gram
Every 8 Hours
CAP-MR
Waiting Final Action 
04/10/2024
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
04/10/2024
04/16/2024
IV
500 LD Then 250
Q24
Cap Mr
Waiting Final Action 
04/15/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/15/2024
04/15/2024
IV
4.5g
Single Dose
ARF Sec To CAP-HR
Waiting Final Action 
04/15/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/15/2024
04/21/2024
IV
2.25g
Q12
ARF Sec To 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: