Maghinay Sr., Romeo R.

HRN: 02-60-56  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/05/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/05/2023
02/12/2023
IV
4.5g
Q6
DM Foot Wagner 5
Waiting Final Action 
02/05/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/05/2023
02/12/2023
IV
600mg
Q6
DM Foot Wagner 5
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: