Dela Cruz, Jaeron Zeik .

HRN: 27-84-43  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/31/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/31/2026
02/07/2026
IV
300 Mg
Q 6 Hours
PCAP-C
Checking Initial Appropriateness 
02/03/2026
CEFTRIAXONE 1G (VIAL)
02/03/2026
02/09/2026
IV
600mg
Q24hours
PCAP-C
Checking Initial Appropriateness 
02/03/2026
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
02/03/2026
02/09/2026
PO
1.8ml
BID
PCAP-C
Checking Initial 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: