Tubal, Lady Jane C.

HRN: 26-54-56  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/18/2025
CEFTRIAXONE 1G (VIAL)
01/18/2025
01/24/2025
IVT
2g
OD
Typhoid
Waiting Final Action 
01/21/2025
CIPROFLOXACIN 500MG (TAB)
01/21/2025
01/28/2025
PO
500mg
Q24h
UTI
Waiting Final Action 
01/21/2025
CIPROFLOXACIN 500MG (TAB)
01/21/2025
01/28/2025
PO
500mg/tab
BID
UTI
Waiting Final Action 
01/22/2025
AZITHROMYCIN 500MG TABLET (TAB)
01/22/2025
01/28/2025
PO
500
OD
UTI,TYPHOID FEVER
Waiting Final Action 
01/25/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
01/25/2025
02/01/2025
IV
3g
Q6H
UTI; T/C Antibiotic Resistance
Waiting Final Action 
01/26/2025
LEVOFLOXACIN 500MG (TAB)
01/26/2025
02/03/2025
ORAL
500mg
BID
Typhoid Fever
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: