Umban, Venerando S.

HRN: 26-27-38  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/28/2025
CEFTRIAXONE 1G (VIAL)
06/28/2025
07/04/2025
IVTT
2g
Once A Day
UTI
Waiting Final Action 
07/05/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
07/05/2025
07/05/2025
IV
4.5g
Loading Dose
Complicated UTI
Checking Initial Appropriateness 
07/05/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
07/05/2025
07/11/2025
IV
2.25g
Q8h
Complicated UTI
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: