Adam, Saiden B.

HRN: 08-93-88  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/03/2026
CEFTRIAXONE 1G (VIAL)
05/03/2026
05/10/2026
IV DRIP IN 30 MINS
1.1g
Q12h
T/C Sepsis
Checking Initial Appropriateness 
05/06/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/06/2026
05/13/2026
IV DRIP
2.2g
Q8hours
Sepsis
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: