Ayon, Salve S.

HRN: 21-40-64  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/25/2023
CEFTRIAXONE 1G (VIAL)
06/25/2023
07/02/2023
IV
1g
OD
Complicated UTI
Waiting Final Action 
06/28/2023
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
06/28/2023
07/05/2023
IV
500mg
OD
CUTI; Pancreatic Cyst
Waiting Final Action 
06/30/2023
LEVOFLOXACIN 500MG (TAB)
06/30/2023
07/07/2023
PO
500m
OD
Pancreatic Complex Cyst; Uti
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: