CaÑete, Rb V.

HRN: 26-63-16  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/01/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
02/01/2025
02/07/2025
IVT
300mg
Q6
Pneumonia
Checking Final Appropriateness 
02/03/2025
FLUOCINOLONE ACETONIDE POLYMYXIN B NEOMYCIN, 5ML OTIC SOLUTION
02/03/2025
02/09/2025
OTIC DROPS
2 Drops
TID
Otitis Media Left
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: