Wate, Tyler .

HRN: 28-77-24  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/31/2026
CEFTRIAXONE 1G (VIAL)
03/31/2026
04/07/2026
IV
400mg
OD
AGE
Checking Initial Appropriateness 
03/31/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
03/31/2026
04/11/2026
50MG
IV
Q8
AGE
Checking Initial Appropriateness 
04/01/2026
AMPICILLIN 250MG (VIAL)
04/01/2026
04/08/2026
IV
200mg
Q6
Sepsis
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: