AniÑon, Lelit L.

HRN: 28-01-61  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/29/2025
CEFTRIAXONE 1G (VIAL)
10/29/2025
11/05/2025
IVTT
2g
OD
CAP
Checking Final Appropriateness 
10/29/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/29/2025
11/04/2025
IV
4.5g
Q6h
Caphr
Checking Final 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: