Elian, Langca K.

HRN: 12-21-64  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/21/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
11/21/2022
11/28/2022
IV
1.5g
Q6hrs
CAP-MR
Waiting Final Action 
11/23/2022
AZITHROMYCIN 500MG TABLET (TAB)
11/23/2022
11/25/2022
PER OREM
500mg
OD
Pulmonary Infection/ Infiltrates
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: