Putal, Cory H.

HRN: 15-08-26  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/03/2022
CEFTRIAXONE 1G (VIAL)
10/03/2022
10/09/2022
IV
2gm
OD
UTI
Waiting Final Action 
10/03/2022
CEFUROXIME 500MG (TAB)
10/03/2022
10/10/2022
ORAL
1 Cap
BID
UTI IN PREGNANCY
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: