Gumalad, Lucio L.

HRN: 12-95-75  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/27/2025
CEFUROXIME 750MG (VIAL)
08/27/2025
09/03/2025
IV
1.5 G Loading Dose Then 750mg IV
Every 12 Hours
Partial Bowel Obstruction
Checking Initial Appropriateness 
08/27/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
08/27/2025
09/03/2025
IV
500mg
Every 8 Hours
Partial Bowel Obstruction
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: