Toledo, Xian Wynn M.

HRN: 26-30-95  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/02/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
12/02/2024
12/08/2024
IV
215mg
Q8hours
T/c Sepsis
Waiting Final Action 
12/02/2024
CEFTRIAXONE 1G (VIAL)
12/02/2024
12/08/2024
IV
2g
Q24hours
T/c Sepsis
Waiting Final Action 
12/03/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/03/2024
12/10/2024
INTRAVENOUS
3.2 Grams
Every 6 Hours
T/c Sepsis
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: