Butalid, Manilyn L.

HRN: 24-68-10  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/07/2024
AMPICILLIN 1GM (VIAL)
03/07/2024
03/13/2024
IV
2g
Q6
PROM X 9 Hours
Checking Final Appropriateness 
03/08/2024
CO-AMOXICLAV 625MG (TAB)
03/08/2024
03/14/2024
PO
1 Tab
BID
NSVD SP EPISIOTOMY AND REPAIR
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: