Jaca, Janos R.

HRN: 13-45-08  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/11/2024
CEFTRIAXONE 1G (VIAL)
04/11/2024
04/18/2024
IV
2g
Every 24hrs
Perforated PUD
Waiting Final Action 
04/11/2024
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
04/11/2024
04/18/2024
IV
500mg
Every 8 Hours
Perforated PUD
Waiting Final Action 
04/20/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/20/2024
04/27/2024
IV
4.5g
Q8H
Sepsis Sec To Perforated Peptic Ulcer
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: