Ibrahim, Myla M.

HRN: 28-87-50  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/16/2024
CEFTRIAXONE 1G (VIAL)
04/16/2024
04/22/2024
IV
3g
OD
UTI
Waiting Final Action 
04/16/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/16/2024
04/22/2024
IV
300mg
Q12
UTI
Waiting Final Action 
04/18/2024
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
04/18/2024
04/25/2024
IV
2.2g
Q 6 Hours
T/C Sepsis
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: