Gervacio, Theresa T.

HRN: 24-54-68  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/29/2024
CEFUROXIME 1.5GM (VIAL)
02/29/2024
03/07/2024
IV
1.5g
Q8
Empiric
Waiting Final Action 
02/29/2024
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
02/29/2024
02/08/2024
IV
600
Now Then Q8
Prophylaxis
Waiting Final Action 
02/29/2024
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
02/29/2024
03/07/2024
IV
500mg
Q8
Prophylaxis
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: