Suhaina, Madag .

HRN: 22-58-38  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/09/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
02/09/2023
02/16/2023
IV
225
Q6hrs
PCAP C
Waiting Final Action 
02/09/2023
CEFUROXIME 750MG (VIAL)
02/09/2023
02/16/2023
IV
300mg
Q8
PCAP C
Waiting Final Action 
02/09/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/09/2023
02/15/2023
IV
135mg
OD
PCAP C
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: