Samson, Jeralyn S.

HRN: 25-25-78  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/08/2024
AMPICILLIN 1GM (VIAL)
06/08/2024
06/10/2024
IV
2 Grams
Q6
PROM X 6 Hours
Waiting Final Action 
06/09/2024
CO-AMOXICLAV 625MG (TAB)
06/09/2024
06/15/2024
PO
625 Mg Tab
1 Tab Bid
PROM X 25 Hrs
Waiting Final Action 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: