Panilagan, Samuel E.

HRN: 12-62-50  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/22/2026
CEFTRIAXONE 1G (VIAL)
06/22/2026
06/28/2026
IV
2g
Od
Intraabdominal
Remove - Pending Acceptance
06/22/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
06/22/2026
06/28/2026
IV
500mg
Q8
Intraabdominal
Remove - Pending Acceptance
06/23/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/23/2026
06/30/2026
IV
4.5 Gm
Q8h
For “E” Exploratory Laparotomy
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: