Lumawan, Kerian Von A.

HRN: 21-34-16  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/10/2022
AMPICILLIN 250MG (VIAL)
05/10/2022
05/17/2022
IVT
130mg
Q12H
Bacterial Skin Infection; T/C Infected Pustulosis
05/10/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
05/10/2022
05/17/2022
IVT
13mg
Q24H
Bacterial Skin Infection; T/C Infected Pustulosis
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: