Alfaro, Merlyn D.

HRN: 01-24-35  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/09/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
07/09/2026
07/15/2026
IV
4.5gm LD Then 2.25gm Iv Q8h
Q8
Cap Mr
Rejected 
07/09/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
07/09/2026
07/15/2026
IV
750mg LDA Then 500mg Iv Q48H
Q48
Cap Mr
Checking Initial Appropriateness 
07/15/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
07/15/2026
07/21/2026
TOPICAL
1%
BID
Decubitus Ulcer
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: