Capa, Sheila Mae .

HRN: 00-72-88  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/16/2025
AMPICILLIN 1GM (VIAL)
05/16/2025
05/23/2025
IVT
2GMS
Q6
PROM
Waiting Final Action 
05/17/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
05/17/2025
05/23/2025
IV
500mg
Q8
SP PLTCS WITH IUD INSERTION
Waiting Final Action 
05/18/2025
CEFUROXIME 500MG (TAB)
05/18/2025
05/25/2025
ORAL
500mg/tab
BID
Sp PLTCS
Waiting Final Action 

AMS Audit Form


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Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: