Montañez, Placida V.

HRN: 03-68-17  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/30/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
06/30/2023
07/07/2023
IV
600mg
Q6
Infected Wound
Waiting Final Action 
07/04/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/04/2023
07/11/2023
IV
1.5g
Q8
CAP-MR
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: