Maulana, Janesa .

HRN: 03-60-46  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/22/2025
AMPICILLIN 1GM (VIAL)
08/22/2025
08/29/2025
IV
2g
Q6hrs
PROM - Thinly MSAF
Checking Initial Appropriateness 
08/22/2025
CEFUROXIME 500MG (TAB)
08/22/2025
08/29/2025
PO
500mg
BID X 7 Days
PROM X 16 Hrs
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: