Bais, Joan L.

HRN: 29-06-11  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/24/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/24/2026
05/30/2026
IV
4.5
Q6h
Cap-hr
Checking Initial Appropriateness 
05/24/2026
AZITHROMYCIN 500MG IV
05/24/2026
05/28/2026
IV
500 Mg
Od
Cap-hr
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: