Sangilan, Maricel S.

HRN: 22-42-92  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/11/2023
AMPICILLIN 1GM (VIAL)
04/11/2023
04/12/2023
IVT
2g
Q6
PROM
Waiting Final Action 
04/11/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
04/11/2023
04/17/2023
IV
500 Mg
Now Then Every 8 Hours For 6 Doses
S/p Lscs
Waiting Final Action 
04/12/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
04/12/2023
04/19/2023
IVTT
240 Mg
Every 12 Hours
S/P LTCS
04/12/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
04/12/2023
04/19/2023
IVTT
80 Mg
OD For 7 Days
S/P Primary LTCS T/C Intraamniotic Infection, Thickly MSAF

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: