Tiate, Blessa Rose Q.

HRN: 23-80-10  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/19/2023
AMPICILLIN 1GM (VIAL)
12/19/2023
12/26/2023
IV
2 GRAMS
Q6
PROM X 5 HRS, MSAF THICKLY
Waiting Final Action 
12/19/2023
CEFUROXIME 1.5GM (VIAL)
12/19/2023
12/26/2023
IV
1.5g
Q8 X 7 Days
S/p Primary LTCS
Waiting Final Action 
12/19/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
12/19/2023
12/26/2023
IV
500mg
Q8 X 7 Days
S/P Primary LTCS
Waiting Final Action 
12/20/2023
CEFUROXIME 500MG (TAB)
12/20/2023
12/27/2023
PO
500 Mg
BID
S/P LSTCS
Waiting Final Action 
12/20/2023
METRONIDAZOLE 500MG (TAB)
12/20/2023
12/27/2023
PO
500 Mg
TID
S/P LSTCS
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: