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
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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
03/18/2026
FLUCONAZOLE 150MG (CAP)
03/18/2026
03/25/2026
PO
160mg
OD
Mouth Sores
Checking Initial Appropriateness 
03/18/2026
CEFTRIAXONE 1G (VIAL)
03/18/2026
03/25/2026
IV
2g
OD
HAP
Checking Initial Appropriateness 
03/19/2026
FLUCONAZOLE 150MG (CAP)
03/19/2026
03/26/2026
PO
200mg
Od
Oral Candidiasis
Checking Initial Appropriateness 
03/20/2026
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
03/20/2026
03/26/2026
ORAL
3cc
Q8
Mouth Ulcers
Remove - Pending Acceptance
03/20/2026
FLUCONAZOLE 2MG/ML, 100ML (VIAL)
03/20/2026
03/26/2026
IV
200mg
Q24
Oral Candidiasis
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: