Gallogo, Jolly Mae .

HRN: 22-86-02  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/10/2023
CEFUROXIME 1.5GM (VIAL)
04/10/2023
04/12/2023
IVT
1.5g
Q8H
UTI
Waiting Final Action 
04/11/2023
METRONIDAZOLE 500MG (TAB)
04/11/2023
04/14/2023
PER OREM
500 Mg
Every 8 Hours For 3 Doses
S/p LSCS With IUD
Waiting Final Action 
04/11/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
04/11/2023
04/13/2023
IV
500 Mg
Every 8 Hours For 3 Doses
S/P LSCS With IUD
Waiting Final Action 
04/10/2023
CEFUROXIME 500MG (TAB)
04/13/2023
04/19/2023
PO
500 Mg
BID
S/P LTCS
Waiting Final Action 
04/13/2023
METRONIDAZOLE 500MG (TAB)
04/13/2023
04/19/2023
PO
500 Mg
TID
S/P LTCS
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: