Ariston, Mary Neriah C.

HRN: 21-40-28  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/22/2022
AMPICILLIN 500MG (VIAL)
05/22/2022
05/29/2022
IV
230
Q6
URtI
Waiting Final Action 
05/23/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/23/2022
05/29/2022
IVT
175mg
Q6h
Pcap C With HRAD
05/23/2022
CEFTRIAXONE 1G (VIAL)
05/23/2022
05/30/2022
IV
460mg
Q24h
Pcap C
Waiting Final Action 
05/24/2022
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
05/24/2022
05/28/2022
PO
1ml
OD
PCAP-C
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: