Abastillas, Aljun T.

HRN: 26-87-56  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/28/2025
CEFTRIAXONE 1G (VIAL)
03/28/2025
04/04/2025
IV
2gms
OD
CAP MR
Waiting Final Action 
03/28/2025
AZITHROMYCIN 500MG TABLET (TAB)
03/28/2025
04/01/2025
PO
500mg
OD
CAP MR
Waiting Final Action 
03/28/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/28/2025
03/28/2025
IV
4.5g
Now
Cap
Waiting Final Action 
03/28/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
03/28/2025
04/18/2025
IV
2.25g
Q6
Cap
Waiting Final Action 
03/28/2025
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
03/28/2025
04/03/2025
IV
500 Mg
Q48
Cap
Waiting Final Action 
04/07/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/07/2025
04/14/2025
IV DRIP
4.5 G
Q8hrs
CAP-MR
Rejected 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: