Camance, Aidelyn C.

HRN: 29-27-56  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/07/2026
CEFTRIAXONE 1G (VIAL)
07/07/2026
07/13/2026
IV
2g
OD
CAP-MR
Checking Initial Appropriateness 
07/07/2026
AZITHROMYCIN 500MG TABLET (TAB)
07/07/2026
07/11/2026
PO
500mg
OD
CAP-MR
Checking Initial Appropriateness 
07/08/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
07/08/2026
07/14/2026
IV
4.5g
Q8
CAPMR
Rejected 
07/09/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
07/09/2026
07/16/2026
IV
2.25g
Q8
Cap Hr
Checking Initial Appropriateness 
07/12/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
07/12/2026
07/19/2026
IV
2.25g
Q6
Cap Hr
Checking Final Appropriateness 
07/12/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
07/12/2026
07/12/2026
IV
750mg
Now As LD
CAP HR
Checking Final Appropriateness 
07/12/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
07/12/2026
07/19/2026
IV
500mg
Q48
Cap Hr
Checking Final 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: