Calago, Marlyn C.

HRN: 12-38-18  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/05/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
07/05/2024
07/11/2024
IVT
4.5g
Q6
CAP HR
Waiting Final Action 
07/05/2024
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
07/05/2024
07/11/2024
IVT
750mg
OD
CAP HR
Waiting Final Action 
07/07/2024
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
07/07/2024
07/14/2024
IV
2.25g
Q 8hrs
CAP-HR
Waiting Final Action 
07/07/2024
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
07/07/2024
07/14/2024
IV
250mg
OD Every Other Day
CAP-HR
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: