Wamilda, Jerillo R.

HRN: 28-56-01  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/11/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/11/2026
02/11/2026
IVT
1GM
ON CALL TO OR
LTCS
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: