Belinario, Allan E.

HRN: 13-84-64  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/28/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/28/2026
05/05/2026
IV
4.5g
Q8
Uti
Checking Initial Appropriateness 
05/03/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
05/03/2026
05/05/2026
IV
2.25g
Q8
Complicated Uti
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: