Caipilan, Jonny C.

HRN: 21-73-90  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/11/2022
CEFUROXIME 1.5GM (VIAL)
08/11/2022
08/17/2022
IV
1.5
Q8
Uti
08/11/2022
CIPROFLOXACIN 500MG (TAB)
08/11/2022
08/17/2022
PO
500
BID
UTI
Waiting Final Action 
08/14/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
08/14/2022
08/21/2022
IV
500mg
Q8
Intraabdominal Infection
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: