Emo, Erlinda D.

HRN: 28-62-16  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/24/2026
AZITHROMYCIN 500MG TABLET (TAB)
02/24/2026
03/01/2026
IVTT
500mg
OD
CAP-High Risk
Remove - Pending Acceptance
02/24/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/24/2026
02/24/2026
IVTT
4.5g
STAT
CAP- High Risk
Remove - Pending Acceptance
02/24/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
02/24/2026
03/03/2026
IVTT
2.25g
Q6H
CAP- High Risk
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: