Barrientos, Evalen .

HRN: 06-50-68  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/26/2023
AMPICILLIN 1GM (VIAL)
09/26/2023
10/03/2023
IV
2gm
Q6
PROM
Waiting Final Action 
09/28/2023
CEFUROXIME 500MG (TAB)
09/28/2023
10/05/2023
PO
500mg
BID X 7 Days
S/P NSVD; PROM
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

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 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: