Villaber, Maria Glaiza M.

HRN: 12-86-57  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/14/2023
CEFUROXIME 500MG (TAB)
07/14/2023
07/21/2023
PO
500 Mg
BID
Urinary Tract Infection
Checking Final Appropriateness 
09/04/2023
AMPICILLIN 1GM (VIAL)
09/04/2023
09/11/2023
IV
2g
Q6
PROM
Waiting Final Action 
09/05/2023
CO-AMOXICLAV 625MG (TAB)
09/05/2023
09/11/2023
PO
625mg
BID
RMLE; NSVD
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: