Tudtud, Maricel .

HRN: 21-02-73  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/26/2025
AMPICILLIN 1GM (VIAL)
05/26/2025
06/01/2025
IV
2g
Q6
G8P6(6016) 40 5/7 Weeks AOG By Late UTZ; PROM X 5 Hrs
Checking Initial Appropriateness 
05/29/2025
CO-AMOXICLAV 625MG (TAB)
05/29/2025
06/05/2025
ORAL
625mg
BID
S/P NSD; PROM
Checking Initial Appropriateness 
05/29/2025
CEFUROXIME 1.5GM (VIAL)
05/29/2025
05/30/2025
IV
1.5g
Q8hrs
PROM
Checking Initial Appropriateness 

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: