Salih, Teresita T.

HRN: 21-53-95  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/14/2022
CEFTRIAXONE 1G (VIAL)
07/14/2022
07/17/2022
IV
2g
OD
Cap-MR
Waiting Final Action 
07/14/2022
AZITHROMYCIN 500MG TABLET (TAB)
07/14/2022
07/15/2022
PO
500mg
OD
CAP-MR
Waiting Final Action 
07/18/2022
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
07/18/2022
07/25/2022
IV
4.5g IV
Q6h
Community-acquired Pneumonia, Medium-risk
07/28/2022
AMPICILLIN 1GM (VIAL)
07/28/2022
08/04/2022
IV
2g
Q6
Cathether Associated UTI
Waiting Final Action 
08/02/2022
FLUCONAZOLE 150MG (CAP)
08/02/2022
08/02/2022
PER NGT
50mgtab
Q24
Uti
Waiting Final Action 
08/06/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/06/2022
08/12/2022
IV
100mg
Q24
CAP HR
Waiting Final Action 
08/06/2022
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
08/06/2022
08/12/2022
IV
500mg
Q24
CAP HR

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: