Salac, Marjorein .

HRN: 28-21-82  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/06/2025
AMPICILLIN 1GM (VIAL)
12/06/2025
12/13/2025
IV
2 Grams
Q6
Prom X 5 Hrs
Checking Initial Appropriateness 
12/06/2025
CEFUROXIME 500MG (TAB)
12/06/2025
12/13/2025
PO
500
Bid
7 Days
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: