Limo, Mark L.

HRN: 21-40-82  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/26/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/26/2022
06/01/2022
IVT
740mg
Q6
UTI, PCAP-C
Waiting Final Action 
05/27/2022
CEFTRIAXONE 1G (VIAL)
05/27/2022
06/03/2022
IV
1.5g
Q24h
Pcap C, Uti
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: