Padillo, Michelle .

HRN: 14-27-13  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/06/2026
CEFAZOLIN 1GM (VIAL)
07/06/2026
07/06/2026
IV
2 Grams PTOR
PTOR
Surgical Prophylaxis
Checking Initial Appropriateness 
07/06/2026
CEFUROXIME 500MG (TAB)
07/06/2026
07/13/2026
PO
500mg
BID
S/P Repeat PLTCS
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: