Paking, Insahaya .

HRN: 26-61-67  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/28/2025
AZITHROMYCIN 500MG TABLET (TAB)
01/28/2025
02/01/2025
PO
500mg
OD
CAP PTB
Waiting Final Action 
01/28/2025
CEFTAZIDIME 1GM (VIAL)
01/28/2025
02/03/2025
IV
2gm
Q8
CAP PTB; T/C Emypema
Waiting Final Action 
02/01/2025
MEBENDAZOLE 500MG (TAB)
02/01/2025
02/01/2025
ORAL
500 MG
HS
Intestinal Parasitism
Waiting Final Action 
02/03/2025
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
02/03/2025
02/09/2025
IV
750 Mg
Q8
For 7 Days
Waiting Final Action 
02/03/2025
CIPROFLOXACIN 500MG (TAB)
02/03/2025
02/09/2025
ORAL
500 Mg
BID
CAP MR
Waiting Final Action 
02/03/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
02/03/2025
02/09/2025
IVTT
750mg
Q8
Hepatic Abscess
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: