Maribao, Regino S.

HRN: 26-24-08  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/21/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/21/2025
08/21/2025
IVTT
4.5g
STAT
Sepsis
Checking Initial Appropriateness 
08/21/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
08/21/2025
08/28/2025
IVTT
2.25g
Q6H
Sepsis
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: