De Loyola, Kiara Princess A.

HRN: 23-76-79  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/02/2023
AMPICILLIN 1GM (VIAL)
11/02/2023
11/09/2023
IVT
134
Q12h
Infection; PROM
Waiting Final Action 
11/02/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
11/02/2023
11/09/2023
IVT
13
Q24
Infection; PROM
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: