Emblode, Johan .

HRN: 28-21-31  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/03/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/03/2025
12/10/2025
IV
245mg
Q6
Pcap C
Checking Initial Appropriateness 
12/06/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
12/06/2025
12/13/2025
IV
32mg
OD
Pcap C
Checking Initial Appropriateness 
12/06/2025
CEFTRIAXONE 1G (VIAL)
12/06/2025
12/13/2025
IV
640mg
OD
Pcap C
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: