Mamonta, Mejolyn C.

HRN: 26-05-43  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/28/2025
CEFTRIAXONE 1G (VIAL)
05/28/2025
06/03/2025
IV
2g
OD
Appendicitis
Checking Initial Appropriateness 
05/28/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
05/28/2025
06/04/2025
IV
500mg
Q8h
ACUTE APPENDICITIS
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: