Manayon, Zyque S.

HRN: 21-91-24  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/06/2022
CEFTAZIDIME 1GM (VIAL)
09/06/2022
09/12/2022
IV
1gm
TID
CAP MR, PTB
Waiting Final Action 
09/11/2022
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
09/11/2022
09/17/2022
ORAL
100,000IU/ml
QID
Oral Thrush
Waiting Final Action 
09/14/2022
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
09/14/2022
09/20/2022
IVT
4.5g
Q6
Immunocompromised State
Waiting Final Action 
09/14/2022
AZITHROMYCIN 500MG TABLET (TAB)
09/14/2022
09/20/2022
PO
1200mg
Once A Week
Immunocompromised State
Waiting Final Action 
09/14/2022
COTRIMOXAZOLE 960MG (TAB)
09/14/2022
09/20/2022
PO
960mg
OD
Immunocompromised State (PCP)
Waiting Final Action 
09/14/2022
AZITHROMYCIN 500MG TABLET (TAB)
09/14/2022
09/20/2022
PO
500mg
Once A Week
Immunocompromised State (MAC)
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: