Puerto, Jershon L.

HRN: 22-60-13  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/11/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
04/11/2023
04/17/2023
IV
600mg
Q6
DM Foot Wagner Grade 4
Waiting Final Action 
04/11/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
04/11/2023
04/17/2023
IV
1.5gm
Q6
DM Foot Wagner Grade 4
Waiting Final Action 
04/12/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
04/12/2023
04/19/2023
IV
2.25g
Q8h
Sepsis
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: