Longayan, Juanita B.

HRN: 12-09-32  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/03/2023
CEFTRIAXONE 1G (VIAL)
02/03/2023
02/09/2023
IV
2gm
Q24
CAP MR
Waiting Final Action 
03/06/2023
CEFTRIAXONE 1G (VIAL)
03/06/2023
03/12/2023
IV
2g
OD
Cap Mr
Waiting Final Action 
03/11/2023
AZITHROMYCIN 500MG TABLET (TAB)
03/11/2023
03/15/2023
ORAL
500mg
Od
Cap Mr
Waiting Final Action 
03/11/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
03/11/2023
03/17/2023
IV
1.5g
Q6h
CAP MR
Waiting Final Action 
03/15/2023
METRONIDAZOLE 500MG (TAB)
03/15/2023
03/21/2023
ORAL
500mg
TID
T/C C. Defficile Infection Sec To Recurrent Antibiotic Use
Waiting Final Action 
03/15/2023
METRONIDAZOLE 500MG (TAB)
03/15/2023
03/21/2023
ORAL
500mg
TID
T/C C. Defficile Infection Sec To Recurrent Antibiotic Use
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: