Pangate, Jerson B.

HRN: 08-91-33  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/23/2025
CEFTRIAXONE 1G (VIAL)
05/23/2025
05/30/2025
IVTT
2g
Q24H
CAPMR
Waiting Final Action 
05/23/2025
AZITHROMYCIN 500MG TABLET (TAB)
05/23/2025
05/28/2025
PO
500mg
OD
Cap-mr
Waiting Final Action 
05/28/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/28/2025
06/03/2025
IV
4.5g
Q6h
CAPMR
Rejected 
05/28/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
05/28/2025
06/03/2025
IV
600mg
Q8h
Infected Wound
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: