Patindol, Francisco T.

HRN: 26-10-33  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/22/2024
CEFTRIAXONE 1G (VIAL)
10/22/2024
10/28/2024
IV
2g
OD
UTI
Waiting Final Action 
10/25/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/25/2024
10/31/2024
IV
1.5g
Q6h
UTI
Waiting Final Action 
10/25/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/25/2024
10/31/2024
IV
750
Q12
Urinary 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: