Montesclaros, Jennelyn T.

HRN: 13-51-39  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/01/2025
CEFUROXIME 1.5GM (VIAL)
09/02/2025
09/02/2025
IV
1.5g
Once
Prophylaxis
Checking Initial Appropriateness 
09/02/2025
CEFUROXIME 1.5GM (VIAL)
09/02/2025
09/06/2025
IVT
1.5
OD
S/P Repeat LTCS
Checking Initial Appropriateness 
09/02/2025
CEFUROXIME 500MG (TAB)
09/02/2025
09/12/2025
PO
500mg
BID
S/P Repeat LTCS
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: