Bernales, Maylin B.

HRN: 21-65-97  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/01/2022
AMPICILLIN 1GM (VIAL)
08/01/2022
08/02/2022
IV
2gm Now Then 1gm Q6
Now Then Q6
PROM X 6 Hours
Waiting Final Action 
08/01/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
08/01/2022
08/02/2022
IV
500mg
Q8hours X 3 Doses
S/P CS
Waiting Final Action 
08/01/2022
CEFUROXIME 1.5GM (VIAL)
08/01/2022
08/02/2022
IV
1.5g
Q8hours X 3 Doses
S/P CS
Waiting Final Action 
08/02/2022
METRONIDAZOLE 500MG (TAB)
08/02/2022
08/09/2022
ORAL
500mg
TID
SP CS; PROM; TMSAF
Waiting Final Action 
08/02/2022
CEFUROXIME 500MG (TAB)
08/02/2022
08/09/2022
ORAL
500mg
BID
SP CS; PROM; TMSAF
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: