Majid, Diana T.

HRN: 12-93-24  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/02/2026
CEFTRIAXONE 1G (VIAL)
06/02/2026
06/08/2026
IV
2G
OD
UTI
Checking Initial Appropriateness 
06/05/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
06/05/2026
06/12/2026
IV
600
Q6h
CRBSI
Checking Final Appropriateness 
06/05/2026
CEFTRIAXONE 1G (VIAL)
06/05/2026
06/12/2026
IV
2gm
Od
Crbsi
Checking Final 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: