Abdurahman, Shahana Ziya D.

HRN: 22-65-29  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/22/2023
AMPICILLIN 250MG (VIAL)
03/22/2023
03/29/2023
IVT
125mg
Q12
PROM X 48 Hours
Waiting Final Action 
03/22/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/22/2023
03/29/2023
IVT
38mg
Q24
PROM X 48 Hours
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: