Villarta, Danylita U.

HRN: 22-75-10  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/15/2023
AMPICILLIN 1GM (VIAL)
03/15/2023
03/22/2023
IV
2grams
Q6
PROM
Waiting Final Action 
03/15/2023
CEFUROXIME 500MG (TAB)
03/15/2023
03/22/2023
PO
500 Mg
BID
PROM, Episiorraphy
Waiting Final Action 
03/15/2023
METRONIDAZOLE 500MG (TAB)
03/15/2023
03/22/2023
PO
500 Mg
Every 8 Hours
PROM, Episiorraphy
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: