Cuison, Joella Faith G.

HRN: 23-53-87  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/05/2023
AMPICILLIN 500MG (VIAL)
10/05/2023
10/12/2023
IV
140mg
Q6hours
PCAP-C
Waiting Final Action 
10/05/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
10/05/2023
10/12/2023
IV
14mg
OD
PCAP-C
Waiting Final Action 
10/08/2023
CEFTRIAXONE 1G (VIAL)
10/08/2023
10/15/2023
IV
280mg
OD
PCAP C
Waiting Final Action 
10/09/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/09/2023
10/15/2023
IV
40mg
OD
PCAP-C
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: