Cabardo, Roxanne .

HRN: 13-63-06  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/15/2026
AMPICILLIN 1GM (VIAL)
02/15/2026
02/17/2026
IV
2 G
Q6h
Grossly Leaking
Checking Initial Appropriateness 
02/16/2026
CEFUROXIME 500MG (TAB)
02/16/2026
02/23/2026
PO
500mg/tab
BID
S/P NSVD With RMLE
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: