Lumantam, Jonathan C.

HRN: 28 36 18  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/02/2026
CEFTRIAXONE 1G (VIAL)
01/02/2026
01/09/2026
IV
2G
OD
Acute Appendicitis
Checking Final Appropriateness 
01/02/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
01/02/2026
01/09/2026
IV
2G
OD
Acute Appendicitis
Checking Final Appropriateness 
01/02/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
01/02/2026
01/09/2026
IV
500MG
Q8H
Acute Appendicitis
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: