Dela Torre, Maria Enely M.

HRN: 23-51-18  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/04/2023
AMPICILLIN 1GM (VIAL)
08/04/2023
08/07/2023
IV
2grams
Q6
Leaking BOW
Checking Final Appropriateness 
08/06/2023
CEFUROXIME 1.5GM (VIAL)
08/06/2023
08/07/2023
IV
1.5g
Q8
Post Op Prophylaxis
Checking Final Appropriateness 
08/06/2023
CEFUROXIME 500MG (TAB)
08/07/2023
08/14/2023
PO
500 Mg
BID
Post Op Prophylaxis
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: