Fernandez, Jenalyn .

HRN: 26-79-67  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/16/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
03/16/2025
03/23/2025
IV
100mg
Q6
Pneumonia
Waiting Final Action 
03/16/2025
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
03/16/2025
03/20/2025
PO
0.7ml
OF
T/C Pertussis
Waiting Final Action 
03/19/2025
CEFTRIAXONE 1G (VIAL)
03/19/2025
03/25/2025
IV
150 Mg
Q12H
PCAP C
Waiting Final Action 
03/22/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/22/2025
03/28/2025
IV
45
Q24
NEONATAL PNEUMONIA
Waiting Final Action 
03/26/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
03/26/2025
04/02/2025
IV
220mg
Q6H
PCAP
Waiting Final Action 
03/26/2025
FLUCONAZOLE 50MG (CAP)
03/26/2025
04/02/2025
PO
20mg
3 X A Week
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: