Mondi, Aya S.

HRN: 12-45-79  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/13/2023
CEFTRIAXONE 1G (VIAL)
06/13/2023
06/20/2023
IV
2g
OD
T/c Septic Shock, ETBD
Waiting Final Action 
06/14/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/14/2023
06/21/2023
IV
1gm
Q6
Sepsis
Waiting Final Action 
06/15/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
06/15/2023
06/21/2023
IV
100mg
OD
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: