Arboleras, Perlito .

HRN: 28-80-39  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/07/2026
CEFTRIAXONE 1G (VIAL)
04/07/2026
04/13/2026
IV
2G
OD
CAP MR
Checking Initial Appropriateness 
04/07/2026
AZITHROMYCIN 500MG TABLET (TAB)
04/07/2026
04/11/2026
ORAL
500 MG
OD
CAP MR
Checking Initial Appropriateness 
04/12/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/12/2026
04/18/2026
IV
4.5gm LD Then 2.25gm Q8
Q6
Cap Hr
Checking Initial Appropriateness 
04/13/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/13/2026
04/19/2026
IV
4.5g
Q6
CAP-MR
Rejected 
04/22/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
04/22/2026
04/28/2026
IV
500 Mg
Q24h
VAP
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: