Gallardo, Analyn C.

HRN: 02-63-32  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/04/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/04/2024
08/04/2024
IV
375mg
Loading Dose
T/c Urosepsis
Waiting Final Action 
08/04/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/05/2024
08/11/2024
IV
280mg
OD
T/c Urosepsis
Waiting Final Action 
08/06/2024
CEFUROXIME 750MG (VIAL)
08/06/2024
08/13/2024
IV
750mg
Q12
T/C Urosepsis
Rejected 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: