Ebina, Teresita P.

HRN: 21-84-86  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/30/2022
CEFTRIAXONE 1G (VIAL)
08/30/2022
09/05/2022
IVT
2g
OD
CAP MR
Waiting Final Action 
08/30/2022
AZITHROMYCIN 500MG TABLET (TAB)
08/30/2022
09/03/2022
PO
500mg
OD
CAP MR
Waiting Final Action 
09/01/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
09/01/2023
09/08/2023
IV
500mg
Q8
Intra-abdominal Infection
Checking Final Appropriateness 
09/01/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
09/01/2023
09/08/2023
IV
2.25g
Q6
CAP MR
09/08/2023
AZITHROMYCIN 500MG TABLET (TAB)
09/08/2023
09/12/2023
ORAL
1 Tab
OD
Pne
Checking Final Appropriateness 
09/10/2023
CEFTAZIDIME 1GM (VIAL)
09/10/2023
09/17/2023
IV
1gm
TID
CAP MR
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: