Gotay, Marciano Sr. T.

HRN: 06-46-88  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/01/2024
AZITHROMYCIN 500MG TABLET (TAB)
10/01/2024
10/12/2024
PO
500mg
OD
CAP-MR; PTB Lost To Follow-up
Waiting Final Action 
10/01/2024
CEFTRIAXONE 1G (VIAL)
10/01/2024
10/07/2024
IVT
2g
OD
CAP-MR; PTB Lost To Follow-up
Waiting Final Action 
10/03/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/03/2024
10/10/2024
IVTT
4.5G
Q8
CAP MR
Rejected 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: