Diez, Alicia T.

HRN: 14-15-82  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/27/2025
CEFTRIAXONE 1G (VIAL)
10/27/2025
11/03/2025
IV
2g
OD
UTI
Checking Final Appropriateness 
10/30/2025
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
10/30/2025
11/06/2025
PO
3cc
BID
Oral Thrush
Checking Final Appropriateness 
11/02/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
11/02/2025
11/02/2025
IVTT
4.5g
Stat Dose
Complicated Urinary Tract Infection, T/c Sepsis
Waiting Final Action 
11/02/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
11/02/2025
11/08/2025
IVTT
2.25 G
Q6
Complicated Urinary Tract Infection, T/c Sepsis
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: