Samal, Johair .

HRN: 25-51-61  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/12/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/12/2025
04/19/2025
IV
4.5
Q8
Acute Pancreatitis
Waiting Final Action 
04/19/2026
CEFTRIAXONE 1G (VIAL)
04/19/2026
04/25/2026
IV
2g
OD
Intraabdominal Infection
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: