Adulfo, Cheryl B.

HRN: 20-49-18  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/01/2022
AMPICILLIN 1GM (VIAL)
09/01/2022
09/07/2022
IVTT
2g
Q6H
IUFD
Waiting Final Action 
09/01/2022
CEFUROXIME 1.5GM (VIAL)
09/01/2022
09/02/2022
IV
1.5 Gms X 2 Doses
Q 8 HRS
S/P LTCS
Waiting Final Action 
09/02/2022
CEFUROXIME 500MG (TAB)
09/02/2022
09/08/2022
ORAL
500
BID
LTCS
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: