Manapad, Alhadz A.

HRN: 23-76-74  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/28/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/28/2023
11/04/2023
IVT
42mg
Q24
Thickly MSAF; PSNB
Checking Final Appropriateness 
10/28/2023
AMPICILLIN 1GM (VIAL)
10/28/2023
11/04/2023
IVT
140mg
Q12
Thickly MSAF; PSNB
Checking Final Appropriateness 
01/06/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/06/2025
01/13/2025
IV
260 Mg
Q6h
Pcap C
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: