Emia, Maria Y.

HRN: 06-15-53  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/01/2022
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/01/2022
10/01/2022
IV
4.5gm
Loading Dose
Septic Shock
Waiting Final Action 
10/01/2022
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
10/01/2022
10/07/2022
IV
2.25gm
QID
Septic Shock
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: