Calderon, Gilbert, Jr. .

HRN: 24-06-52  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/18/2023
AMPICILLIN 250MG (VIAL)
12/18/2023
12/25/2023
IVT
250mg
Q12
UTI
Waiting Final Action 
12/18/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
12/18/2023
12/25/2023
IVT
60mg
Q24
UTI
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: