Delosa, Ayesha Mae M.

HRN: 21-40-08  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/21/2022
AMPICILLIN 500MG (VIAL)
05/21/2022
05/28/2022
IV
230mg
Q6
AGE With Mod DHN, BFS, Pcap B
Waiting Final Action 
05/21/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
05/21/2022
05/28/2022
IV
46mg
OD
AGE With Mod DHN, BFS, PCAP B
Waiting Final Action 
05/22/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/22/2022
05/28/2022
IVTT
460mg
Q6
Pcap B

AMS Audit Form


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Initial appropriateness:



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Final appropriateness:



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