Salota, Evangeline A.

HRN: 22-58-06  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/07/2023
CEFTRIAXONE 1G (VIAL)
02/07/2023
02/13/2023
IV
2gm
Q24
BPUD
Waiting Final Action 
02/07/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
02/07/2023
02/13/2023
IV
2.25gm
Q6
Spontaneous Bacterial Peritonitis
Waiting Final Action 
02/15/2023
CEFTRIAXONE 1G (VIAL)
02/15/2023
02/21/2023
IVT
2g
OD
Step Down From Pip-Taz
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

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 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: