Go, Rosalio B.

HRN: 00-42-03  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/01/2022
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/01/2022
05/08/2022
IV
4grams
Q6hours
Presumptive TB, Cellulitis, Left Leg
Waiting Final Action 
05/02/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/02/2022
05/08/2022
IV
1.5g
Q6hours
Presumptive TB, Cellulitis, Left Leg
Waiting Final Action 
05/03/2022
AZITHROMYCIN 500MG TABLET (TAB)
05/03/2022
05/07/2022
PO
500
OD
Pneumonia(CAP-MR)
Waiting Final Action 
05/13/2022
CEFTRIAXONE 1G (VIAL)
05/13/2022
05/20/2022
IV
2g
OD
T/C HAP
Waiting Final Action 
05/22/2022
MUPIROCIN 2%, 15G (TUBE)
05/22/2022
05/28/2022
TOPICAL
2%
2x
Skin Infection
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: