Tulipas, Ayesha Jellica C.

HRN: 21-51-11  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/25/2022
CEFUROXIME 1.5GM (VIAL)
06/25/2022
07/02/2022
IVT
1.5g
Q8H
For D&C
Waiting Final Action 
06/26/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
06/26/2022
07/03/2022
IVT
500mg
Q8H
S/P Completion Curettage With UTZ Guidance
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: