Pelong, Diosdado B.

HRN: 07-15-14  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/21/2023
CLARITHROMYCIN 500MG (CAP)
03/21/2023
03/28/2023
PO
500mg
BID
CAP MR
Waiting Final Action 
03/21/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
03/21/2023
03/28/2023
IV
1.5gms
Q6
CAP MR
Waiting Final Action 
03/27/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/27/2023
03/27/2023
IV
4.5 Grams
Once
CAP-MR
Waiting Final Action 
03/27/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
03/27/2023
04/06/2023
IV
2.25 Grams
Q6H
CAP-MR
Waiting Final Action 
04/05/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
04/05/2023
04/07/2023
IV
2.25g
Q6H
CAP-MR
Waiting Final Action 
04/13/2023
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
04/13/2023
04/20/2023
TOPICAL
Apply Generously To Affected Site
BID
Heat Rash
Waiting Final Action 
05/30/2023
CEFTAZIDIME 1GM (VIAL)
05/30/2023
06/05/2023
IVT
1g
Q8
Pneumonia
Waiting Final Action 
05/30/2023
LEVOFLOXACIN 500MG (TAB)
05/30/2023
06/05/2023
PO
500mgtab
OD
Pneumonia
Waiting Final Action 
05/30/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
05/30/2023
06/05/2023
IVT
600mg
Q6
Aspiration Pneumonia
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: