Lumeran, Jerald Kurt D.

HRN: 21-74-74  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/16/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
11/16/2025
11/23/2025
IV DRIP
565mg
Q6
PCAP C
Checking Final 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: