Tiu, Josefina T.

HRN: 08-25-98  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/18/2026
CEFTRIAXONE 1G (VIAL)
02/18/2026
02/25/2026
IV
2g
OD
CAP MR
Checking Initial Appropriateness 
02/18/2026
AZITHROMYCIN 500MG TABLET (TAB)
02/18/2026
02/22/2026
PO
500
OD
CAP MR
Checking Initial Appropriateness 
02/27/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/27/2026
03/06/2026
IV
4.5g
Q6hrs
CAP MR
Remove - Pending Acceptance
02/28/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/28/2026
03/07/2026
IV
600mg
Q8H
Empyema
Checking Initial Appropriateness 
03/07/2026
CIPROFLOXACIN 500MG (TAB)
03/07/2026
03/13/2026
PO
500mg Tab
BID
EMPYEMA RIGHT LUNG CAP MR
Remove - Pending Acceptance
03/10/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
03/10/2026
03/31/2026
IV
9grams
Q8
Lung Abscess
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: