Banugon, Jeron Rey A.

HRN: 19-39-40  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/20/2023
CEFTRIAXONE 1G (VIAL)
10/20/2023
10/27/2023
IV
1.3g
Q24h
Pcap C
Checking Final Appropriateness 
10/21/2023
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
10/21/2023
10/28/2023
TOPICAL
1ml
QID
Mouth Sores
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: