Tejas, Francisco D.

HRN: 22-86-55  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/13/2023
CEFTRIAXONE 1G (VIAL)
04/13/2023
04/19/2023
IV
2gm
Q24
DM Foot Wagner Grade 3
Waiting Final Action 
04/13/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
04/13/2023
04/19/2023
IV
600mg
Q6
DM Foot Wagner Grade 3
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: