Alejandro Jr, Regieland A.

HRN: 26-35-42  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/12/2024
AZITHROMYCIN 500MG TABLET (TAB)
12/12/2024
12/16/2024
PO
500mg
OD
Massive Ascites; Presumptive PTB
Waiting Final Action 
12/15/2024
CEFTRIAXONE 1G (VIAL)
12/15/2024
12/21/2024
IVT
2g
OD
CAP MR
Waiting Final Action 
12/23/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/23/2024
12/30/2024
IVTT
1.5g
Q8H
PNEUMONIA
Waiting Final Action 
01/06/2025
LEVOFLOXACIN 500MG (TAB)
01/06/2025
01/12/2025
PO
500mg
OD
Ascites; Sepsis
Waiting Final Action 
01/06/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
01/06/2025
01/12/2025
IV
4.5g
Q6
Sepsis; Ascites
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: