Tano, Charity B.

HRN: 26-33-00  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/02/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/02/2024
12/02/2024
IV
4.5g LD
LD
CAP- HR
Waiting Final Action 
12/02/2024
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
12/02/2024
12/09/2024
IV
2.25g
Q8
CAP-HR
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: