Sugabo, Ma. Devena B.

HRN: 26-63-28  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/03/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
02/03/2025
02/04/2025
IVTT
240mg
OD
S/P LTCS Thinly Msaf
Waiting Final Action 
02/03/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/03/2025
02/04/2025
IVTT
900mg
Q8
S/P LTCS , Thinly Msaf
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: