Berual, Merhana .

HRN: 24-67-37  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/14/2025
AMPICILLIN 500MG (VIAL)
01/14/2025
01/21/2025
IV
340
Q6
Pcap C
Waiting Final Action 
01/14/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
01/14/2025
01/21/2025
IV
102
Q24
Pcap C
Waiting Final Action 
01/15/2025
CEFUROXIME 1.5GM (VIAL)
01/15/2025
01/21/2025
IV
230
Q8
PCAP C
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: