Rubio, Jayson D.

HRN: 09-13-77  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/11/2025
CEFTRIAXONE 1G (VIAL)
09/11/2025
09/18/2025
IV
2 Gram
OD
CAP MR
Checking Initial Appropriateness 
09/11/2025
AZITHROMYCIN 500MG TABLET (TAB)
09/11/2025
09/15/2025
PO
500 Mg
OD
CAP MR
Checking Initial Appropriateness 
09/12/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
09/12/2025
09/12/2025
IV
4.5
Now
CAP-MR
Checking Initial Appropriateness 
09/12/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
09/12/2025
09/19/2025
IV
2.25g
Q8h
CAP-MR
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: