Ingcong, Nor-ainne A.

HRN: 16-99-11  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/04/2025
CEFUROXIME 500MG (TAB)
10/04/2025
10/11/2025
PO
500mg
BID
UTI
Checking Initial Appropriateness 
10/07/2025
CEFTRIAXONE 1G (VIAL)
10/07/2025
10/13/2025
IV
2 Grams
Once A Day
T/C Septic Shock
Checking Initial Appropriateness 
10/07/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
10/07/2025
10/13/2025
IV
300mg
Every 6 Hours
T/C Septic Shock
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: