Ompoy, Clarence Jade F.

HRN: 22-56-08  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/26/2023
AMPICILLIN 500MG (VIAL)
09/26/2023
10/03/2023
IV
395mg
Q6
PCAP-C
Waiting Final Action 
09/28/2023
CEFTRIAXONE 1G (VIAL)
09/28/2023
10/05/2023
IV
800mg
Q24h
Pcap C
Checking Final Appropriateness 

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: