Dahiroc, Rachel L.

HRN: 04-03-01  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/02/2025
CEFTRIAXONE 1G (VIAL)
06/02/2025
06/09/2025
IV
2G
OD
UTI
Waiting Final Action 
06/09/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/09/2025
06/16/2025
IV
250mg
Q24H
UTI
Waiting Final Action 
06/09/2025
AZITHROMYCIN 500MG TABLET (TAB)
06/09/2025
06/13/2025
PO
500mg
OD
CAP
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: