Laya, Radzma M.

HRN: 22-58-05  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/07/2023
AMPICILLIN 1GM (VIAL)
02/07/2023
02/14/2023
IV
2g
Q6
Prom Tmsaf
Waiting Final Action 
02/07/2023
CEFUROXIME 1.5GM (VIAL)
02/07/2023
02/07/2023
IV
1.5
On Call OR
Ltcs
Waiting Final Action 
02/08/2023
CEFUROXIME 500MG (TAB)
02/08/2023
02/15/2023
PO
500 Mg
BID
S/P 1°LTCS
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: