Gansubin, Juanito G.

HRN: 15-98-89  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/10/2025
CIPROFLOXACIN 500MG (TAB)
11/10/2025
11/16/2025
PO
500mg
BID
AGE W/ Moderate Dehydration
Waiting Final Action 
11/12/2025
METRONIDAZOLE 500MG (TAB)
11/12/2025
11/18/2025
ORAL
500mg
TID
AGE
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: