Repaja, Janrey .

HRN: 28-15-45  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/24/2025
CEFTRIAXONE 1G (VIAL)
11/24/2025
11/30/2025
IV
2g
OD
Acute Appendicitis
Checking Initial Appropriateness 
11/24/2025
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
11/24/2025
11/30/2025
IV
500mg
Q8
Acute Appendicitis
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: