Gulane, Michelle C.

HRN: 22-99-66  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/04/2023
CEFUROXIME 1.5GM (VIAL)
05/04/2023
05/05/2023
IVTT
1.5
Q8H
T/C Ectopic Pregnancy Vs Septic Abortion
Waiting Final Action 
05/04/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
05/04/2023
05/11/2023
IVT
500mg
Q8H
T/c Ectopic Pregnancy Vs Septic Abortion
Waiting Final Action 
05/06/2023
DOXYCYCLINE 100MG (CAP)
05/06/2023
05/13/2023
PO
100mg
BID
S/P Pelvic Laparotomy
Waiting Final Action 
05/08/2023
METRONIDAZOLE 500MG (TAB)
05/08/2023
05/15/2023
ORAL
500mg
BID
S/p Pelvic Lap; Ectopic Pregnancy
Waiting Final Action 
05/08/2023
CEFUROXIME 500MG (TAB)
05/08/2023
05/15/2023
ORAL
500mg
BID
S/p Pelvic Lap; Ectopic Pregnancy
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: