Tapales, Roldan P.

HRN: 22-32-42  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/15/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
08/15/2023
08/22/2023
IV
500mg
Q8h
Fistulotomy
Checking Final Appropriateness 
08/15/2023
CEFTRIAXONE 1G (VIAL)
08/15/2023
08/22/2023
IV
2g
Q24h
S/p Fistulotomy
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: