Pinid, Elden .

HRN: 15-21-47  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/20/2026
CEFTRIAXONE 1G (VIAL)
05/20/2026
05/20/2026
IVT
2g
Anst Ptor
For Stat Pelvic Lap
Checking Initial Appropriateness 
05/20/2026
METRONIDAZOLE 500MG (TAB)
05/20/2026
05/26/2026
IVTT
500mg
Q8hr
Sp Pelvic Lap
Checking Initial Appropriateness 
05/20/2026
CEFTRIAXONE 1G (VIAL)
05/20/2026
05/26/2026
IV
2g
OD
Sp Pelvic Lap
Checking Initial Appropriateness 
05/22/2026
DOXYCYCLINE 100MG (CAP)
05/22/2026
05/28/2026
ORAL
100mg
BID
SP PELVIC LAP
Checking Initial Appropriateness 
05/22/2026
METRONIDAZOLE 500MG (TAB)
05/22/2026
05/28/2026
ORAL
500mg
TID
Sp Pelvic Lap
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: