Ramos, Harra Lou S.

HRN: 24-18-57  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/01/2023
CEFUROXIME 1.5GM (VIAL)
12/01/2023
12/08/2023
IV
1.5
Q8
Acute Appendicitis
Waiting Final Action 
12/01/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
12/01/2023
12/08/2023
IV
500mg
Q8
Acute Appendicitis
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: