Aslani, Jack Perez .

HRN: 22-76-89  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/13/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/13/2023
12/20/2023
IV
120mg
Q6H
PCAP B
Waiting Final Action 
12/13/2023
MUPIROCIN 2%, 15G (TUBE)
12/13/2023
12/20/2023
TOPICAL
Ample Amount
TID
Skin Infection
Waiting Final Action 
12/16/2023
CEFTRIAXONE 1G (VIAL)
12/16/2023
12/22/2023
IVT
225mg
Q12
UTI
Waiting Final Action 

AMS Audit Form


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Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: