Mangangot, Mark Caleb R.

HRN: 24-14-40  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/07/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/07/2025
01/14/2025
IV
210 Mg
Q6h
Pcap C
Waiting Final Action 
01/08/2025
CEFTRIAXONE 1G (VIAL)
01/08/2025
01/14/2025
IV
320 Mg
Q12
PCAP-C
Waiting Final Action 
01/10/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
01/10/2025
01/16/2025
IV
50mg
Q12
PCAP C
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: