Mejorada, Mary Joy .

HRN: 28-23-71  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/10/2025
AMPICILLIN 1GM (VIAL)
12/10/2025
12/11/2025
IV
2g
Q6
Prom X 3hrs
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: