Balulao, Vaniessa Mea B.

HRN: 21-53-05  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/11/2022
CEFTRIAXONE 1G (VIAL)
07/11/2022
07/18/2022
IV DRIP
500mg
OD
PCAP-C
Waiting Final Action 
07/11/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
07/11/2022
07/18/2022
IV
27mg
OD
PCAP-C
Waiting Final Action 
07/12/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
07/12/2022
07/18/2022
IVT
55mg
Q8 For 7 Days
Amoebiasis
Waiting Final Action 
07/14/2022
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
07/14/2022
07/20/2022
PO
2.5ml
TID X 7 Days
Abdominal Infection
Waiting Final Action 
07/14/2022
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
07/14/2022
07/20/2022
PO
0.6ml
Q6 X 7 Days
Oral Ulcer
Waiting Final Action 
08/15/2022
CEFTAZIDIME 1GM (VIAL)
08/15/2022
08/21/2022
IVT
180mg
Q8hours
PCAP C
Waiting Final Action 
08/16/2022
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
08/16/2022
08/22/2022
IVTT
540mg
Q8 For 7 Days
Pneumonia
Waiting Final Action 
08/24/2022
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
08/24/2022
08/28/2022
PO
1.4
OD
Pneumonia
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: