Gramatica, Arnel B.

HRN: 28-01-32  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/27/2025
CEFTRIAXONE 1G (VIAL)
10/27/2025
11/03/2025
IV
2gm
OD
TC PMBO
Checking Final Appropriateness 
10/27/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
10/27/2025
11/03/2025
IV
500mg
Q8
TC PMBO
Checking Final Appropriateness 
11/02/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
11/02/2025
11/08/2025
IV
4.5g
Q8H
TC PMBO
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: