Gelison, Sheila Ma L.

HRN: 24-18-68  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/02/2023
AMPICILLIN 1GM (VIAL)
12/02/2023
12/08/2023
IV
2 Grams
Q6
PROM
Waiting Final Action 
12/02/2023
AMPICILLIN 1GM (VIAL)
12/02/2023
12/08/2023
IV
2 Grams
Q6
PROM
Waiting Final Action 
12/02/2023
CEFUROXIME 500MG (TAB)
12/02/2023
12/08/2023
PO
1 Tab
Q12
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: