Dela Cerna, Nickson Skyler .

HRN: 25-74-76  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/02/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/02/2025
01/09/2025
IV
300mg
Q6h
PCAP
Waiting Final Action 
01/04/2025
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
01/04/2025
01/10/2025
PO
2.5ml
Q12h
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: