Mirafuentes, Den Marc K.

HRN: 21-23-92  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/14/2022
AMPICILLIN 250MG (VIAL)
04/14/2022
04/21/2022
IV
250
Q6
CAP MR
Waiting Final Action 
04/14/2022
AMPICILLIN 250MG (VIAL)
04/14/2022
04/21/2022
IV
250
Q12
PNEUMONIA
Waiting Final Action 
09/05/2022
CEFUROXIME 750MG (VIAL)
09/05/2022
09/11/2022
IVT
275mg
Tid
Uti
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: