Maribao, Kim Estila L.

HRN: 25-79-04  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/14/2025
CEFTRIAXONE 1G (VIAL)
12/14/2025
12/20/2025
IV DRIP
1.5g
OD
PCAP
Checking Final Appropriateness 
12/18/2025
CEFTAZIDIME 1GM (VIAL)
12/18/2025
12/24/2025
IVT
750mg
Q8
Sepsis
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: