Dialan, Ganiel A.

HRN: 19-58-87  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/28/2023
CEFTRIAXONE 1G (VIAL)
04/28/2023
05/04/2023
IV
2g
Q24
Uti
Checking Final Appropriateness 
04/28/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/28/2023
05/04/2023
IV
300mg
OD
UTI
Checking Final Appropriateness 
04/28/2023
OXACILLIN 500MG (VIAL)
04/28/2023
05/04/2023
IV
1g
Q6
Pcap
Checking Final Appropriateness 
04/30/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
04/30/2023
05/16/2023
IV
1.5g
Q6Hrs
Sepsis
Waiting Final Action 
05/02/2023
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
05/02/2023
05/09/2023
PO
15ml
TID
Amoebiasis
Waiting Final Action 
05/07/2023
OXACILLIN 500MG (VIAL)
05/07/2023
05/10/2023
IV
1000mg
Q6
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: