Sumaham, Glenn R.

HRN: 27-58-95  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/11/2026
AZITHROMYCIN 500MG TABLET (TAB)
03/11/2026
03/15/2026
PO
500mg
Od
CAP
Checking Initial Appropriateness 
03/11/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/11/2026
03/18/2026
IV
4.5g
Q8
Sepsis
Checking Initial Appropriateness 
03/12/2026
COTRIMOXAZOLE 960MG (TAB)
03/12/2026
03/18/2026
PO
2 TABS
TID
PCP Pneumonia
Checking Initial Appropriateness 
03/12/2026
FLUCONAZOLE 2MG/ML, 100ML (VIAL)
03/12/2026
03/18/2026
IV
200mg
OD
PCP PNEUMONIA
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: