Manlangit, Mario T.

HRN: 21-65-22  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/28/2022
CEFTRIAXONE 1G (VIAL)
07/28/2022
08/03/2022
IV
2g
7days
Pneumonia
Waiting Final Action 
07/28/2022
AZITHROMYCIN 500MG TABLET (TAB)
07/28/2022
08/03/2022
PO
500mg
OD
Pneumonia
Waiting Final Action 
08/01/2022
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/01/2022
08/07/2022
IVTT
4.5
Q6
HAP
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: