Gubantes, Paulino L.

HRN: 21-74-93  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/05/2022
CEFTRIAXONE 1G (VIAL)
08/05/2022
08/11/2022
IV
2 G
OD
CAP-MR
Waiting Final Action 
08/05/2022
AZITHROMYCIN 500MG TABLET (TAB)
08/05/2022
08/09/2022
PO
500 Mg
OD
CAP-MR
Waiting Final Action 
08/05/2022
CLINDAMYCIN 150MG/ML, 4ML (AMP)
08/05/2022
08/11/2022
IV
600 Mg
Q6H
CAP-MR

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: