Latasan, Berna Rose S.

HRN: 24-02-66  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/06/2023
CEFUROXIME 500MG (TAB)
11/06/2023
11/12/2023
PO
1 Tab
BID
Thickly MSAF
Checking Final Appropriateness 
11/06/2023
METRONIDAZOLE 500MG (TAB)
11/06/2023
11/12/2023
PO
1 Tab
TID
Thickly MSAF
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: