Tabanao, Jhon Mike V.

HRN: 22-82-20  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/05/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/05/2023
04/11/2023
IV
375
OD
PCAP
Waiting Final Action 
04/05/2023
CEFTRIAXONE 1G (VIAL)
04/05/2023
04/11/2023
IV
2gm
OD
PCAP
Waiting Final Action 
04/07/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
04/07/2023
04/13/2023
IV DRIP
2.5
OD
Pcap
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: