Suhay, Flabiano L.

HRN: 29-11-81  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/09/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/09/2026
06/15/2026
IV
4.5gm
Q6
Cap Hr
Checking Initial Appropriateness 
06/09/2026
AZITHROMYCIN 500MG IV
06/09/2026
06/15/2026
IV
500mg
Q24
Cap Hr
Checking Initial Appropriateness 
06/11/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
06/11/2026
06/15/2026
IV
2.25gm
Q6h
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: