Basanta, Miachel Y.

HRN: 22-29-20  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/07/2022
CEFTRIAXONE 1G (VIAL)
12/07/2022
12/13/2022
IV
2g
Od
Cap Mr
Waiting Final Action 
12/07/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
12/07/2022
12/13/2022
IV
500mg
Q6h
T/C Tetanus Infection
Waiting Final Action 
12/07/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/07/2022
12/13/2022
IV INFUSION
1.5g
Q6
T/C Tetanus Infection, CAP-MR
Waiting Final Action 
12/08/2022
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/08/2022
12/14/2022
IV
4.5g LD Then 2.25mg Q6h
Q6h
Severe Sepsis
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: