Madjus, Mariel B.

HRN: 27-79-89  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/11/2025
AMPICILLIN 1GM (VIAL)
09/11/2025
09/18/2025
IV
2g
Q6h
THINLY MSAF
Checking Initial Appropriateness 
09/12/2025
CO-AMOXICLAV 625MG (TAB)
09/12/2025
09/19/2025
PO
1 Tab
Q8h
PROM X 6 Hours
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: