Jayari, Asmer E.

HRN: 29-23-23  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/29/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/29/2026
07/06/2026
IV
200MG
Q6H
PCAP
Remove - Pending Acceptance
07/01/2026
CEFTRIAXONE 1G (VIAL)
07/01/2026
07/08/2026
IV
400 Mg
Q24h
Pneumonia Severe
Remove - Pending Acceptance
07/02/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/02/2026
07/10/2026
IV
20mg
Q8
PCAP-C
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: