Pantalita, Ann Janine B.

HRN: 26-54-99  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/20/2025
CEFUROXIME 500MG (TAB)
01/20/2025
01/27/2025
PO
500mg
BID X 7 Days
UTI In Pregnancy
Waiting Final Action 
01/24/2025
AMPICILLIN 1GM (VIAL)
01/24/2025
01/30/2025
PO
2g
Q6
G4P0(0030);Preterm Labor; Gestational DM; RPL
Waiting Final Action 
01/24/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
01/24/2025
01/30/2025
IV
600mg
Q8
G4P0(0030);PretermLabor;GestationalDM; RPL; UTI
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: