Isnain, Sitti Farrah S.

HRN: 28-53-97  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/12/2026
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
07/12/2026
07/19/2026
PO
2.5 ML
TID
INTESTINAL AMOEBIASIS
Checking Initial Appropriateness 
07/12/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/12/2026
07/19/2026
IV
168MG
Q6
PCAP C
Checking Initial Appropriateness 
07/13/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
07/13/2026
07/20/2026
IV
70mg
Q8h
Amoebiasis
Checking Final Appropriateness 
07/14/2026
CEFTRIAXONE 1G (VIAL)
07/14/2026
07/20/2026
IV
600mg
OD
PCAP C
Checking Final Appropriateness 
07/19/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
07/19/2026
07/25/2026
IV
90mg
Q8
Intraabdominal Infection
Checking Final Appropriateness 
07/19/2026
CEFTRIAXONE 1G (VIAL)
07/19/2026
07/25/2026
IV
740mg
OD
Intraabdominal Infection
Checking Final Appropriateness 
07/26/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
07/26/2026
08/02/2026
IV
590mg
Q6
ASA
Remove - Pending Acceptance
07/26/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
07/26/2026
07/29/2026
IV
90mg
Q8
ASA
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: