Salapuddin, Mudzremar K.

HRN: 27-03-57  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/25/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
04/25/2025
05/01/2025
IV
325
Q6
PCAP C
Waiting Final Action 
04/26/2025
CEFTRIAXONE 1G (VIAL)
04/26/2025
05/03/2025
IV
650mg
OD
T/C CNSI; PCAP
Waiting Final Action 
04/26/2025
ACICLOVIR 400MG (TAB)
04/26/2025
05/17/2025
PO PER NGT
110mg
TID
CNSI; T/C Japanese Encephalitis
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: