Din, Mary Glaiza Mikaela B.

HRN: 04-19-31  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/24/2023
CEFUROXIME 1.5GM (VIAL)
11/24/2023
12/01/2023
IV
1.5g
Q8
Acute Appendicitis
Checking Final Appropriateness 
11/24/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
11/24/2023
12/01/2023
IV
500mg
Q8H
Acute Appendicitis
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: