Calib-og, Brent Xander L.

HRN: 25-06-24  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/19/2024
CEFTRIAXONE 1G (VIAL)
05/19/2024
05/25/2024
IV
850mg
OD
PCAP C
Waiting Final Action 
05/25/2024
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
05/25/2024
05/31/2024
IV
680
Q6
Sepsis
Waiting Final Action 
05/25/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/25/2024
05/31/2024
IV
60mg
Q12h
PCAP C
Waiting Final Action 
05/30/2024
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
05/30/2024
06/05/2024
PO
2mL
BID
Sepsis
Waiting Final Action 
05/31/2024
CLINDAMYCIN 150MG/ML, 4ML (AMP)
05/31/2024
06/07/2024
IV
85mg
Q6
Phlebitis
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: