Perocho, Carlito G.

HRN: 04-74-10  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/20/2024
CEFTRIAXONE 1G (VIAL)
07/20/2024
07/27/2024
IV
2g
OD
CAP-MR
Waiting Final Action 
07/21/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
07/21/2024
07/28/2024
IV
4.5gms
Q6
CAP HR
Waiting Final Action 
07/21/2024
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
07/21/2024
07/28/2024
IV
750mg
OD
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: