Sajulga, Kice Nhate C.

HRN: 23-16-72  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/22/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/22/2023
06/29/2023
IVTT
85mg
Q24
AGE
Waiting Final Action 
06/22/2023
CEFTRIAXONE 1G (VIAL)
06/22/2023
06/29/2023
IVTT
285mg
Q12
AGE
Waiting Final Action 
06/23/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
06/23/2023
06/29/2023
IVTT
600mg
Q8h
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: