Pandial, Florendina .

HRN: 02-96-85  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/18/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/18/2026
05/25/2026
IV
4.5
Q8
HAP
Checking Initial Appropriateness 
05/18/2026
LEVOFLOXACIN 500MG (TAB)
05/18/2026
05/25/2026
PO
500
OD
HAP
Checking Initial Appropriateness 
05/19/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/19/2026
05/25/2026
IV
1000
Od
HAP (ESBL E Cloacae) L
Checking Initial Appropriateness 
05/19/2026
ACICLOVIR 400MG (TAB)
05/19/2026
05/25/2026
PO
400 Mg
Od
HAP (ESBL E CLOACAE) P Aeroginosa
Checking Initial Appropriateness 
05/19/2026
COTRIMOXAZOLE 960MG (TAB)
05/19/2026
05/25/2026
PO
800/160 Mg Tab
MWF
HAP EBSL E Cloacae
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: