Sarino, Rosemarie R.

HRN: 21-85-40  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/09/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
08/09/2024
08/15/2024
IVTT
1 Amp
Q8Hrs
Appendicitis
Waiting Final Action 
08/09/2024
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
08/09/2024
08/15/2024
IV
250mg
Q8hrs
Appendicitis
Waiting Final Action 
08/09/2024
CEFAZOLIN 1GM (VIAL)
08/09/2024
08/15/2024
IV
1g
Q8
Acute Appendicitis
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: