Sumatra, Benjie .

HRN: 00-23-17  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/08/2022
CEFTRIAXONE 1G (VIAL)
06/08/2022
06/14/2022
IVT
2g
Od
Uti
Waiting Final Action 
06/14/2022
CIPROFLOXACIN 500MG (TAB)
06/14/2022
06/20/2022
PO
500 Mg
BID
UTI
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: