Quilo, Elsie T.

HRN: 29-02-88  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/22/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/22/2026
05/28/2026
IV
4.5g
Q6h
CAP-MR
Checking Initial Appropriateness 
05/22/2026
LEVOFLOXACIN 500MG (TAB)
05/22/2026
05/26/2026
PO
500 Mg
OD
CAP-MR
Checking Initial Appropriateness 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: