Sumagang, Jerick .

HRN: 22-44-03  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/18/2023
AMPICILLIN 500MG (VIAL)
02/18/2023
02/25/2023
IV
350 Mg
Q6
Sepsis
Waiting Final Action 
02/18/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/18/2023
02/25/2023
IV
68 Mg
Q24
Sepsis
Waiting Final Action 
02/18/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/18/2023
02/25/2023
IV
33 Mg
Q6
Sepsis
Waiting Final Action 
02/18/2023
CEFTRIAXONE 1G (VIAL)
02/18/2023
02/25/2023
IV
450 Mg
Q24
T/C Sepsis
Waiting Final Action 
03/05/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/05/2023
03/11/2023
IV DRIP
450mg
Q8
T/C Sepsis, VAP
Waiting Final Action 
03/05/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
03/05/2023
03/11/2023
IV
22mg
OD
T/C Sepsis, VAP
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: