Cabilao, Bb Girl .

HRN: 27-07-53  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/10/2025
AMPICILLIN 250MG (VIAL)
05/10/2025
05/17/2025
IV DRIP
150mg
Q12 Hours
PSNB (PROM X 3 Days)
Waiting Final Action 
05/10/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/10/2025
05/17/2025
IV DRIP
45mg
Q24hours
PSNB (PROM X 3 Days)
Waiting Final Action 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: