Mondalis, Ambali L.

HRN: 22-00-26  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/28/2022
CEFTRIAXONE 1G (VIAL)
09/28/2022
10/06/2022
IV
2grams
OD
Septicemia
Waiting Final Action 
12/30/2022
CEFTRIAXONE 1G (VIAL)
12/30/2022
01/05/2023
IV
2gm
Q24
Uti
Waiting Final Action 
12/30/2022
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
12/30/2022
01/05/2023
TOPICAL
Ample Amount
Bid
Decubitus Ulcer
Waiting Final Action 
12/31/2022
RIFAXIMIN 200MG (TAB)
12/31/2022
01/06/2023
PO
200mgtab
Bid
Intraabdominal Infection
Waiting Final Action 

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: