Tizon, Cresencio T.

HRN: 23-88-74  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/12/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/12/2023
10/18/2023
IV
1.5g
Q6
T/C Teranus Infection
Checking Final Appropriateness 
10/12/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
10/12/2023
10/18/2023
IV
500mg
Q6
T/C Tetanus Infection
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: