Sumampong, Justine Kay .

HRN: 28-13-34  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/17/2026
AMPICILLIN 1GM (VIAL)
01/17/2026
01/18/2026
IV
2g
Every 6 Hours
Ruptured BOW
Checking Initial Appropriateness 
01/18/2026
CO-AMOXICLAV 625MG (TAB)
01/18/2026
01/25/2026
ORAL
625mg
BID
S/P NSD With Repair; Thinly MSAF
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: