Alta, Rowena O.

HRN: 18-43-49  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/28/2025
CEFTAZIDIME 1GM (VIAL)
05/28/2025
06/03/2025
IV
2g
Q8h
CAPMR
Waiting Final Action 
05/28/2025
LEVOFLOXACIN 500MG (TAB)
05/28/2025
06/03/2025
PO
500mg
Q8h
CAPMR
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: