Jaji, Norhana .

HRN: 22-76-24  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/14/2023
AMPICILLIN 250MG (VIAL)
07/14/2023
07/20/2023
IVT
115
Q6hrs
Pcap C
Waiting Final Action 
07/16/2023
CEFTRIAXONE 1G (VIAL)
07/16/2023
07/22/2023
IV
450mg
OD
PCAP-D
Waiting Final Action 
07/18/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/18/2023
07/25/2023
IVTT
68mg
Q24
PCAP C
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: