Lasdoce, Jaybe Theo C.

HRN: 24-68-24  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/09/2024
AMPICILLIN 500MG (VIAL)
03/09/2024
03/16/2024
IV
400mg
Q6hours
PCAP-C
Waiting Final Action 
03/10/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/10/2024
03/16/2024
IV
120mg
Q24h
PCAP C
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: