Miro, Elvie Jane I.

HRN: 03-25-93  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/07/2023
AMPICILLIN 1GM (VIAL)
04/07/2023
04/08/2023
IV
2 Grams
Every 6 Hours
PROM
Waiting Final Action 
04/08/2023
CEFUROXIME 1.5GM (VIAL)
04/08/2023
04/10/2023
IVT
1.5g
Q8H
S/P Primary LTCS
Waiting Final Action 
04/08/2023
CEFUROXIME 500MG (TAB)
04/10/2023
04/17/2023
PO
500mg
BID
S/P Primary LTCS With IUD
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: