Dalagon, Apple Grace P.

HRN: 16-94-77  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/20/2022
ACICLOVIR 800MG (TAB)
06/20/2022
06/25/2022
PER OREM
800mg
Q6
VZV Infection
Waiting Final Action 
06/20/2022
CEFUROXIME 1.5GM (VIAL)
06/20/2022
06/27/2022
IVTT
1.5g
Q8
Pulmonary Infection
Waiting Final Action 
06/23/2022
CEFTRIAXONE 1G (VIAL)
06/23/2022
06/30/2022
IV
2gm
OD
PC TNTC
Waiting Final Action 
09/10/2022
AMPICILLIN 1GM (VIAL)
09/10/2022
09/11/2022
IV
2g
Q6h
Prom X 10hrs
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: