Dela Cruz, Regina S.

HRN: 14-57-37  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/18/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
11/18/2024
11/25/2024
IV
4.5g
Q8
CAP
Waiting Final Action 
11/18/2024
AZITHROMYCIN 500MG TABLET (TAB)
11/18/2024
11/23/2024
PO
500mg
OD
CAP
Waiting Final Action 
11/21/2024
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
11/21/2024
11/28/2024
IV
500MG
OD
CAP MR
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: