Mayo, Jun S.

HRN: 21-93-20  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/19/2022
CEFTRIAXONE 1G (VIAL)
12/19/2022
12/26/2022
IV
2 Grams
Q24H
T/c CAP-MR
Waiting Final Action 
12/19/2022
AZITHROMYCIN 500MG TABLET (TAB)
12/19/2022
12/24/2022
PO
1 Tab
OD
T/c CAP-MR
Waiting Final Action 
12/23/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/23/2022
12/30/2022
IV
1.5 Grams
Q6H
CAP-MR
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: