Jayme, Gloria B.

HRN: 01-87-26  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/25/2023
CEFTRIAXONE 1G (VIAL)
10/25/2023
10/31/2023
IV
2grams
OD
CAP-MR
Checking Final Appropriateness 
10/25/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/25/2023
10/29/2023
ORAL
500mg/tab
OD
CAP-MR
Checking Final Appropriateness 
10/27/2023
CEFTAZIDIME 1GM (VIAL)
10/27/2023
11/03/2023
IV
1g
Q8H
CAP MR Presumptive PTB; Sepsis
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: