Pepito, Charmelyn .

HRN: 14-82-18  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/08/2023
AMPICILLIN 1GM (VIAL)
12/08/2023
12/15/2023
IV
2g
Q6
Prom
Checking Final Appropriateness 
12/08/2023
CEFUROXIME 1.5GM (VIAL)
12/08/2023
12/08/2023
IV
1.5gm
Now
Pre-op Prophylaxis For CS
Checking Final Appropriateness 
12/09/2023
CEFUROXIME 500MG (TAB)
12/09/2023
12/15/2023
ORAL
500mg
BID
S/P CS
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: