Capablanca, Rose A.

HRN: 26-37-54  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/03/2025
AMPICILLIN 250MG (VIAL)
02/03/2025
02/10/2025
IV
200mg
Q6h
Pneumonia
Waiting Final Action 
02/03/2025
CEFOTAXIME 500MG (VIAL)
02/03/2025
02/10/2025
IV
150mg
Q6hours
PCAP-C
Waiting Final Action 
02/09/2025
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
02/09/2025
02/15/2025
PO
1.2ml
BID
PCAP C
Waiting Final Action 
02/10/2025
CEFTRIAXONE 1G (VIAL)
02/10/2025
02/16/2025
IV
200mg
Q12
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: