Mabanal, Jessa .

HRN: 28-60-51  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/22/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/22/2026
02/22/2026
IV
4.5g
Loading Now
UTI
Remove - Pending Acceptance
02/22/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
02/22/2026
03/01/2026
IV
2.25g
Q8H
UTI
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: