Tactac, Guillermo P.

HRN: 26-10-46  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/14/2025
AZITHROMYCIN 500MG TABLET (TAB)
12/14/2025
12/18/2025
ORAL
500mg
OD
CAP-MR
Checking Final Appropriateness 
12/14/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/14/2025
12/14/2025
IV
4.5g
Now
CAP-MR
12/14/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
12/14/2025
12/20/2025
IV
2.25g
Q6
CAP-MR

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: