Pon-pon, Grace .

HRN: 24-48-64  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/09/2024
CEFUROXIME 500MG (TAB)
02/09/2024
02/16/2024
PO
500mg
Q8
S/P LTCS
Checking Final Appropriateness 
02/09/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
02/09/2024
02/16/2024
IV
240mg
OD
S/P LTCS
Checking Final Appropriateness 
02/09/2024
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/09/2024
02/16/2024
IV
900mg
Q8
S/P LTCS
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: