Pantakan, Waren G.

HRN: 28 43 25  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/18/2026
CEFTRIAXONE 1G (VIAL)
01/18/2026
01/24/2026
IV
2gm
Q12
T/C Typhoid Psychosis
Checking Initial Appropriateness 
01/22/2026
ACICLOVIR 800MG (TAB)
01/22/2026
01/29/2026
IV
500
Q8
Viral Encephalitis
Checking Initial Appropriateness 
01/22/2026
ACICLOVIR 250MG VIAL (I.V. INFUSION)
01/22/2026
02/05/2026
IV
500
Q8
Viral Encephalitis
Checking Initial Appropriateness 
01/25/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
01/25/2026
02/01/2026
IV
4.5
Q8
CAP HR
Checking Initial Appropriateness 
01/28/2026
FLUCONAZOLE 50MG (CAP)
01/28/2026
02/04/2026
PO
150
OD
Candidiasis
Checking Initial 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: