Gomez, Divina D.

HRN: 26-41-11  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/17/2025
AMPICILLIN 1GM (VIAL)
02/17/2025
02/19/2025
IV
2 G
Q6
PROM
Waiting Final Action 
02/18/2025
CEFUROXIME 1.5GM (VIAL)
02/18/2025
02/18/2025
IV
1.5 Grams
PTOR
OR Prophylaxis
Waiting Final Action 
02/18/2025
CEFUROXIME 1.5GM (VIAL)
02/18/2025
02/19/2025
IV
1.5g
1.5g IV X 3 Doses
S/p Primary Lstcs
Waiting Final Action 
02/18/2025
CEFUROXIME 500MG (TAB)
02/18/2025
02/25/2025
PO
500mg Tab
1 Tab BID X 7 Days
S/p Primary Lstcs
Waiting Final Action 
02/18/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
02/18/2025
02/19/2025
IV
500mg
500mg Iv Q8 X3dosss
S/p Primary Lstcs
Waiting Final Action 
02/18/2025
METRONIDAZOLE 500MG (TAB)
02/18/2025
02/25/2025
PO
500mg
1 Tab BID X 7 Days
S/p Primary Lstcs
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: