Ayson, Flora Mae C.

HRN: 17-57-89  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/18/2025
AMPICILLIN 1GM (VIAL)
06/18/2025
06/20/2025
IV
2 G
Q6
PROM , Thickly MSAF
Waiting Final Action 
06/18/2025
CEFUROXIME 500MG (TAB)
06/18/2025
06/25/2025
ORAL
500 Mg/tab
Bid
Thickly Msaf
Waiting Final Action 
06/18/2025
METRONIDAZOLE 500MG (TAB)
06/18/2025
06/25/2025
ORAL
500 Mg/tab
TID
Thickly Msaf
Waiting Final Action 

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: