Gojo, Javelle B.

HRN: 28-18-59  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/30/2025
AMPICILLIN 250MG (VIAL)
11/30/2025
07/12/2025
IV
140mg
Q12h
Sepsis
Checking Initial Appropriateness 
11/30/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
11/30/2025
12/07/2025
IV
12mg
Q24HRS
Sepsis
Checking Initial Appropriateness 
11/30/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
03/11/2025
12/07/2025
IV
40mg As LD Then 20mg
Q8
Tetanus
Checking Initial Appropriateness 
12/03/2025
CEFOTAXIME 500MG (VIAL)
12/03/2025
12/17/2025
IV
140mg
Q12
Neonatal Tetanus
Checking Final Appropriateness 
12/15/2025
CEFOTAXIME 500MG (VIAL)
12/15/2025
12/22/2025
IV
140mg
Q12h
Neonatal Sepsis
Checking Final Appropriateness 
12/17/2025
CEFTAZIDIME 1GM (VIAL)
12/17/2025
12/24/2025
IV
140mg
Q8
Neonatal Sepsis
Checking Final Appropriateness 
12/27/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
12/27/2025
01/02/2026
IVT
200mg
Q8
Sepsis
Checking Initial Appropriateness 
12/27/2025
FLUCONAZOLE 50MG (CAP)
12/27/2025
01/02/2026
PO
35mg
Now
Loading Dose
Checking Initial Appropriateness 
12/27/2025
FLUCONAZOLE 50MG (CAP)
12/27/2025
01/02/2026
PO
25mg Pptab
OD
Prophylaxis
Checking Initial Appropriateness 
01/03/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
01/03/2026
01/10/2026
IV
224mg
Q6hours
Sepsis
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: