Cantallopez, Jovelyn R.

HRN: 18-43-36  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/06/2026
CEFTAZIDIME 1GM (VIAL)
04/06/2026
04/12/2026
IV
2g
Q8
CAP-MR
Checking Initial Appropriateness 
04/07/2026
AZITHROMYCIN 500MG TABLET (TAB)
04/07/2026
04/11/2026
ORAL
500
OD
CAP
Checking Initial Appropriateness 
04/07/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/07/2026
04/14/2026
IV
4.5grams
Q6h
CAP-MR; HIE
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: