Diong, Roland C.

HRN: 21-51-74  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/29/2022
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/29/2022
07/06/2022
IVT
4.5
Q6
Diabetic Foot
Waiting Final Action 
06/29/2022
CLINDAMYCIN 150MG/ML, 4ML (AMP)
06/29/2022
07/06/2022
IV
600
Q8
Diabetic Foot
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: