De Fiesta, Marilou L.

HRN: 28-85-42  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/28/2026
CEFTRIAXONE 1G (VIAL)
04/28/2026
05/04/2026
IV
1g
Q12
Hernia Nucleus Pulposus
Remove - Pending Acceptance
04/28/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/28/2026
04/29/2026
IV
1g
1 Dose Only. Prior To OR
Herniated Nucleus Pulposus L4L5
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: