Sicad, Analuna I.

HRN: 01-28-07  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/20/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/20/2026
03/27/2026
IV
4.5
Q8
CAP HR
Checking Initial Appropriateness 
03/20/2026
LEVOFLOXACIN 500MG (TAB)
03/20/2026
03/27/2026
PO
500
OD
CAP HR
Checking Initial Appropriateness 
03/21/2026
CEFTRIAXONE 1G (VIAL)
03/21/2026
03/28/2026
IV
2g
OD
CAPMR
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: