Gajusta, Jiecel J.

HRN: 21-32-08  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/07/2022
AMPICILLIN 1GM (VIAL)
05/07/2022
05/14/2022
IVTT
2g
Q6H
PROM X 24H
Waiting Final Action 
05/07/2022
AMPICILLIN 1GM (VIAL)
05/07/2022
05/14/2022
IVTT
2g
Q6H
PROM X 24H
Waiting Final Action 
05/07/2022
CEFUROXIME 500MG (TAB)
05/07/2022
05/14/2022
PO
500mg
Q12H
UTI
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: