Bandianon, Avelina .

HRN: 27-70-05  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/25/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/25/2025
08/25/2025
IV
4.5g
Loading Dose
Complicated Uti
Checking Initial Appropriateness 
08/25/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
08/25/2025
08/31/2025
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: