Alingasa, Relmar C.

HRN: 22-64-33  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/24/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/24/2023
03/03/2023
I
4.5gram
Q6hr
CAP-MR; T/C Immunocompromised State
Waiting Final Action 
02/24/2023
AZITHROMYCIN 500MG TABLET (TAB)
02/24/2023
02/28/2023
ORAL
500mg
OD
CAP-MR
Waiting Final Action 
02/24/2023
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
02/24/2023
03/03/2023
ORAL
400,000 U
Q6hrs
Oral Candidiasis
Waiting Final Action 
03/01/2023
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
03/01/2023
03/07/2023
IV
2-3ml
Q6
Oral Candidiasis
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: