Hinog, Kiara .

HRN: 22-39-51  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/04/2023
AMPICILLIN 500MG (VIAL)
04/04/2023
04/11/2023
IV
150mg
Q6hours
PCAP-C
Waiting Final Action 
04/05/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
04/05/2023
04/12/2023
IV
150mg
Q6H
PCAP
Waiting Final Action 
04/06/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/06/2023
04/12/2023
IVT
45mg
Od
Pcap C
Waiting Final Action 
04/06/2023
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
04/06/2023
04/10/2023
PO
0.4
Od
T/c Pertussis
Waiting Final Action 
04/10/2023
CEFTAZIDIME 1GM (VIAL)
04/10/2023
04/16/2023
IVT
150 Mg
Q8
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: