Sahirani, Nahla E.

HRN: 24-80-99  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/30/2024
AMPICILLIN 1GM (VIAL)
04/30/2024
05/06/2024
IV
165mg
Q12
Acute Skin Bacterial Infection
Waiting Final Action 
04/30/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/30/2024
05/06/2024
IV
49mg
Q24
Acute Skin Bacterial Infection
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: