Mesa, Nefertilyn .

HRN: 29-10-10  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/04/2026
CEFAZOLIN 1GM (VIAL)
06/04/2026
06/04/2026
IVT
2g
SD
CS
Checking Final Appropriateness 
06/04/2026
CEFAZOLIN 1GM (VIAL)
06/04/2026
06/07/2026
IV
1 G
Q8 For 9 Doses
S/p LTCS
Checking Final Appropriateness 
06/04/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
06/04/2026
06/06/2026
IV
500
Q8 For 4 Doses
S/P LTCS
Checking Final Appropriateness 
06/04/2026
METRONIDAZOLE 500MG (TAB)
06/04/2026
06/11/2026
PO
500
Tid
S/P LTCs
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: