Mansul, Hazel Grace E.

HRN: 28-62-29  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/25/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/25/2026
03/04/2026
IVTT
4.5g
Q8H
CAP-HR
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: