Pollescas, Kenth Ivan .

HRN: 22-11-43  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/31/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/31/2022
11/07/2022
IV
380 Mg
Q8
Age With Mod Dhn; T/C PSGN
Waiting Final Action 
11/01/2022
AMPICILLIN 500MG (VIAL)
11/01/2022
11/08/2022
IV
500 Mg
Q6
AGE With Moderate Dehydration
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: