Solaiman, Imbran A.

HRN: 24-45-04  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/08/2024
AMPICILLIN 500MG (VIAL)
07/08/2024
07/14/2024
IVTT
375
Q6H
PCAP C
Waiting Final Action 
07/09/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/09/2024
07/16/2024
IV
100mg
Q24hours
PCAP-C
Waiting Final Action 
07/11/2024
CEFUROXIME 750MG (VIAL)
07/11/2024
07/18/2024
IV
250mg
Q8hours
PCAP-C
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: