Libre, Lance T.

HRN: 20-91-67  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/04/2022
AMPICILLIN 500MG (VIAL)
07/04/2022
07/10/2022
IV
165mg
Q6h
Pcap C
Waiting Final Action 
07/04/2022
CEFTRIAXONE 1G (VIAL)
07/04/2022
07/10/2022
IV
325mg
Q12
Pcap C
Waiting Final Action 
07/13/2022
CEFUROXIME 750MG (VIAL)
07/13/2022
07/20/2022
IV
170mg
Q8H
UTI
Waiting Final Action 
12/05/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/05/2022
12/11/2022
IVT
175mg
Q6hrs
Urti; Age With Mod DHn
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: