Sodicta, Jickram .

HRN: 23-39-44  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/11/2023
AMPICILLIN 250MG (VIAL)
08/11/2023
08/17/2023
IVT
150mgq
Q6hrs
Pcap C
Checking Final Appropriateness 
08/11/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
08/11/2023
08/17/2023
IVT
28mg
Q24hrs
Pcap C
Checking Final Appropriateness 
08/13/2023
CEFUROXIME 750MG (VIAL)
08/13/2023
08/20/2023
IV
185mg
Q8
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: