Vistal, Charles G.

HRN: 05-45-43  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/29/2026
CIPROFLOXACIN 500MG (TAB)
07/29/2026
08/05/2026
PO
500mg
BID
Complicated UTI
Remove - Pending Acceptance
08/01/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/01/2026
08/07/2026
IV
4.5
Q6h
Urosepsis
Remove - Pending Acceptance
08/11/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/11/2026
08/18/2026
IV
4.5g
Q6
ARF; HIE Sec To CAP MR With Aspiration Component
Checking Initial Appropriateness 
08/11/2026
AZITHROMYCIN 500MG TABLET (TAB)
08/11/2026
08/15/2026
PO
500mg Tab
Od
ARF; HIE Sec To CAP MR With Aspiration Component
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: