Fernandez, Jeraldin .

HRN: 26-79-68  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/16/2025
AMPICILLIN 250MG (VIAL)
03/16/2025
03/23/2025
IV
130mg
Q6h
PCAP-C
Waiting Final Action 
03/16/2025
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
03/16/2025
03/20/2025
PO
0.8ml
OD
T/C Pertussis
Waiting Final Action 

AMS Audit Form


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Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: