Catubig, Jaquilyn R.

HRN: 19-84-92  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/07/2022
AMPICILLIN 250MG (VIAL)
07/07/2022
07/14/2022
IV
200mg
Q6h
PCAP-C
Waiting Final Action 
07/07/2022
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
07/07/2022
07/14/2022
IV DRIP
790mg Of Piperacillin
Q8h
PCAP-C With Atelectasis
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: