Belano, Roweno L.

HRN: 26-88-72  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/24/2025
CEFTAZIDIME 1GM (VIAL)
03/24/2025
03/31/2025
IV
1g
Every 8 Hours
DM Foot, Right
Waiting Final Action 
03/24/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
03/24/2025
03/31/2025
IV
600mg
Every 8 Hours
DM Foot, Right
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: