Supe, Cristituta P.

HRN: 18-99-79  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/04/2025
CEFTRIAXONE 1G (VIAL)
01/04/2025
01/11/2025
IV
2g
OD
CAP MR
Waiting Final Action 
01/04/2025
AZITHROMYCIN 500MG TABLET (TAB)
01/04/2025
01/09/2025
ORAL
500mg
OD
CAP MR
Waiting Final Action 
01/04/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
01/04/2025
01/10/2025
IV
4.5g
Q6
CAP MR, AGE
Waiting Final Action 
01/04/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
01/04/2025
01/10/2025
IV
500mg
Q6
AGE
Waiting Final Action 
01/08/2025
CO-AMOXICLAV 625MG (TAB)
01/08/2025
01/14/2025
PO
500 Mg/tab, 1 Tab
Bid
Cap Mr Step Down
Waiting Final Action 
01/09/2025
METRONIDAZOLE 500MG (TAB)
01/09/2025
01/15/2025
PO
500 Mg/tab, 1 Tab
TID
Gastroenteritis Oral Step Down
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: