Ulangkaya, Hasheer .

HRN: 23-17-98  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/02/2023
AMPICILLIN 500MG (VIAL)
11/02/2023
11/08/2023
IV
285mg
Q6
Pcap C
Waiting Final Action 
11/02/2023
MUPIROCIN 2%, 15G (TUBE)
11/02/2023
11/08/2023
TOPICAL
Ample Amount
BID
Bacterial Infection
Waiting Final Action 
11/04/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
11/04/2023
11/10/2023
IV
80mg
Q24h
PCAP C
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: