Dionaldo, Rose D.

HRN: 12-94-88  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/30/2022
CEFTRIAXONE 1G (VIAL)
09/30/2022
09/30/2022
IVT
2g
Loading Dose
STAT PELVIC LAP
Waiting Final Action 
10/01/2022
CEFTRIAXONE 1G (VIAL)
10/01/2022
10/08/2022
IV
1g
Q12
Post Op Prophylaxis
Waiting Final Action 
10/01/2022
CEFUROXIME 500MG (TAB)
10/01/2022
10/07/2022
PO
500 Mg
BID
S/p Pelvic Lap
Waiting Final Action 
10/02/2022
DOXYCYCLINE 100MG (CAP)
10/02/2022
10/16/2022
PO
1 Tab
BID
S/P EL
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: