Montecillo, Jimmy A.

HRN: 27-46-58  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/16/2025
CO-AMOXICLAV 625MG (TAB)
07/16/2025
07/22/2025
PO
625
BID
Urti
Checking Initial Appropriateness 
07/19/2025
CEFTRIAXONE 1G (VIAL)
07/19/2025
07/25/2025
IV
2gm
OD
T/c Typhoid Infection
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: