Halop, Gerald D.

HRN: 28-56-67  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/15/2026
CEFTRIAXONE 1G (VIAL)
02/15/2026
02/22/2026
IV
1g
OD ANST
Acute Appendicitis
Checking Initial Appropriateness 
02/15/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
02/15/2026
02/22/2026
IV
500mg
Q8HRS
Acute Appendicitis
Checking Initial Appropriateness 
02/16/2026
CEFTRIAXONE 1G (VIAL)
02/16/2026
02/23/2026
IV
2g
OD
Acute Appendicitis
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: