Tambac, Zian L.

HRN: 20-43-65  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/19/2023
CEFUROXIME 1.5GM (VIAL)
10/19/2023
10/26/2023
IVT
430mg
Q8
URTI
Checking Final Appropriateness 
10/20/2023
CEFTRIAXONE 1G (VIAL)
10/20/2023
10/27/2023
IV
1.3gm
OD
Complex Febrile Seizure
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: