Vergis, Rowena U.

HRN: 19-47-95  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/01/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/01/2024
10/08/2024
IV
1.5 Grams
Q8H
Fournier's Gangrene
Waiting Final Action 
10/01/2024
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
10/01/2024
10/08/2024
IV
500mg
Q8H
Fournier's Gangrene
Waiting Final Action 
10/01/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/01/2024
10/01/2024
IV
4.5g
Loading Dose
T/C Fournier’s Gangrene
Waiting Final Action 
10/01/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/01/2024
10/10/2024
IV
2.25g
IV
Q8
Waiting Final Action 
10/07/2024
CLINDAMYCIN 150MG/ML, 4ML (AMP)
10/07/2024
10/14/2024
IVT
600 Mg
Q8h
Infected Bartholin Cyst
Waiting Final Action 
10/09/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/09/2024
10/16/2024
IV
1.5g
Q8
Infected Bartholins Cyat Right Labia Majora
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: