Jailani, Samera M.

HRN: 27-93-51  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/29/2026
AMPICILLIN 1GM (VIAL)
06/29/2026
07/05/2026
IV
765mg
Q6
UTI
Checking Initial Appropriateness 
06/30/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
06/30/2026
07/07/2026
TOPICAL
-
BID
IV-borne Infiltrate
Checking Initial Appropriateness 
06/30/2026
MEBENDAZOLE 100MG/5ML, 60ML SUSPENSION
06/30/2026
07/03/2026
PO
5ml
Q 12
T/C Ascariasis
Checking Initial Appropriateness 
07/02/2026
CEFTRIAXONE 1G (VIAL)
07/02/2026
07/09/2026
IV
1g
Now Then OD
UTI
Checking Initial Appropriateness 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: