Senarlo, Miguela M.

HRN: 28-68-00  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/07/2026
CEFTAZIDIME 1GM (VIAL)
03/07/2026
03/14/2026
IV
2G
OD
CAP MR
Remove - Pending Acceptance
03/07/2026
AZITHROMYCIN 500MG TABLET (TAB)
03/07/2026
03/12/2026
PO
500MG
OD
CAP MR
Remove - Pending Acceptance
03/09/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/09/2026
03/16/2026
IV
4.5g
Q 8 Hours
Infection
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: