AMS Audit

Juarez, Jaily .

HRN: 28-69-74 Sex: Male

Patient Encounter

AMS Audit List

Audit Date

Antimicrobial

Start Date

End Date

Route

Dose

Frequency

Indication Documented

CEFTRIAXONE 1G (VIAL)

TYPHOID ENCEPHALOPATHY

Checking Initial Appropriateness

METRONIDAZOLE 500MG (TAB)

INTRACRANIAL MASS LEFT LIKELY ABSCESS CANNOT TOTALLY RULE OUT BACTERIAL MENINGITIS

Checking Initial Appropriateness

CEFTRIAXONE 1G (VIAL)

INTRACRANIAL MASS LEFT LIKELY ABSCESS CANNOT TOTALLY RULE OUT BACTERIAL MENINGITIS

Checking Initial Appropriateness

ACICLOVIR 250MG VIAL (I.V. INFUSION)

Viral Encephalitis

Remove - Pending Acceptance

ACICLOVIR 400MG (TAB)

Remove - Pending Acceptance

MUPIROCIN 2%, 15G (TUBE)

Apply On Affected Area

Infected Wound, Upper Lip

Checking Initial Appropriateness

LEVOFLOXACIN 5MG/ML, 100ML (VIAL)

VAP (S. Marcenscens)

Checking Initial Appropriateness

COTRIMOXAZOLE 960MG (TAB)

VAP (S. Marcescens)

Remove - Pending Acceptance

AMIKACIN 250MG/ML, 2ML (VIAL/AMP)

Remove - Pending Acceptance

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Apply To Affected Area

Remove - Pending Acceptance

ACICLOVIR 400MG (TAB)

Remove - Pending Acceptance

AMS Audit Form

Start Date: End Date:

Indication:

Prophylaxis Empiric Culture-directed Empirical Escalation Empirical de-escalation Empiric then culture-directed

Type of Infection:

Urinary tract Pneumonia URTI Bloodstream Bone & joint Skin & soft tissue Intra-abdominal Eye, ear, nose, throat, & mouth Cardiovascular Reproductive tract Central nervous system

Febrile neutropenia Disseminated systemic infection Unspecified sepsis Multiple infections (tick all sites) Prophylaxis

Compliance to guidelines:

Compliant to guidelines Non-compliant to guidelines Guideline not available

Initial appropriateness:

Yes No

If inappropriate:

No infection Wrong choice Wrong route Wrong dose

Final appropriateness:

Yes No

Overall appropriateness:

Yes No