Ripo, Zaphet Jay N.

HRN: 23-66-12  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/23/2023
AMPICILLIN 250MG (VIAL)
10/23/2023
10/30/2023
IV
190MG
Q12H
PCAP C
Waiting Final Action 
10/23/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/23/2023
10/30/2023
IV
50MG
IV
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: