Fernandez, Gladys Gay C.

HRN: 14-90-33  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/29/2022
CEFUROXIME 1.5GM (VIAL)
05/29/2022
05/29/2022
IV
1.5g
LD
Pre Op Prophylaxis
Waiting Final Action 
05/29/2022
CEFUROXIME 1.5GM (VIAL)
05/29/2022
06/05/2022
IV
1.5gm
Q8
Retained Placenta S/p Completion Curettage
Waiting Final Action 
05/29/2022
CEFUROXIME 500MG (TAB)
05/30/2022
06/06/2022
ORAL
500mg
BID
Retained Placenta S/P LTCS
Waiting Final Action 
05/30/2022
METRONIDAZOLE 500MG (TAB)
05/30/2022
06/05/2022
ORAL
500mg
TID
Retained Placenta S/P LTCS
Waiting Final Action 
05/05/2023
CEFUROXIME 1.5GM (VIAL)
05/06/2023
05/06/2023
IVT
1.5 G
On Call Prior To OR
Elective CS
Waiting Final Action 
05/06/2023
CEFUROXIME 1.5GM (VIAL)
05/06/2023
05/07/2023
IVTT
1.5g
Q8H X 6 Doses
S/P LTCS
Waiting Final Action 
05/06/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
05/06/2023
05/07/2023
IV
500mg
Q8H X 6 Doses
S/P LTCS
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: