Puyod, Agripino B.

HRN: 27-22-65  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/06/2025
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
06/06/2025
06/10/2025
IVT
500mg
Q24H
CAP-HR
Remove - Pending Acceptance
06/06/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/06/2025
06/12/2025
IVT
4.5
Q24H
CAP-HR
Remove - Pending Acceptance
06/06/2025
CEFTAZIDIME 1GM (VIAL)
06/06/2025
06/13/2025
IV
1gram
Q8h
CAP HR
Remove - Pending Acceptance
06/08/2025
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
06/08/2025
06/14/2025
IV
500mg
Q24
Cap-hr
Remove - Pending Acceptance
06/08/2025
CEFTAZIDIME 1GM (VIAL)
06/08/2025
06/14/2025
IV
500mg
Q24
Cap-hr
Remove - Pending Acceptance
06/10/2025
LEVOFLOXACIN 500MG (TAB)
06/10/2025
06/16/2025
PO
500 Mg/tab, 1 Tab
OD
CAp-HR ; Oral Step Down
Checking Initial Appropriateness 
06/10/2025
CEFTAZIDIME 1GM (VIAL)
06/10/2025
06/17/2025
IV
1g
Q8H
CAP HR
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: