Sigba, Cjay .

HRN: 22-77-52  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/10/2023
AMPICILLIN 250MG (VIAL)
11/10/2023
11/17/2023
IV
250mg
Q6hours
PCAP-C; R/o PTB
Checking Final Appropriateness 
11/11/2023
CEFTRIAXONE 1G (VIAL)
11/11/2023
11/17/2023
IV
500mg
OD
PCAP-C
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: