Dinolan, Jemson -.

HRN: 29-21-00  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/22/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/22/2026
06/29/2026
IV
457, 000 Units
Q6H
PCAP C
Remove - Pending Acceptance
06/22/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/22/2026
06/29/2026
IV
500mg
Q6H
PCAP C
Remove - Pending Acceptance
06/22/2026
CEFTRIAXONE 1G (VIAL)
06/22/2026
06/29/2026
IV
480mg
Q12H
Acute Gastroenteritis With Moderate Dehydration
Remove - Pending Acceptance

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: