General, Elizabeth O.

HRN: 24-69-32  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/15/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
03/15/2024
03/21/2024
IV
1.5gm
Q6
CAP MR
Waiting Final Action 
03/15/2024
AZITHROMYCIN 500MG TABLET (TAB)
03/15/2024
03/19/2024
PO
500mg
Q24
Cap Mr
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: