Lipapa, Zyrex .

HRN: 25-40-54  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/19/2024
AMPICILLIN 250MG (VIAL)
11/19/2024
11/26/2024
IV
205mg
Q6h
PCAP C
Waiting Final Action 
11/19/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
11/19/2024
11/25/2024
IV
60
Q24Hrs
PCAP
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: