Pano, Michelle Q.

HRN: 20-74-73  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/18/2026
CEFAZOLIN 1GM (VIAL)
02/18/2026
02/18/2026
IVTT
2g
PTOR
For Completion Curettage
Checking Initial Appropriateness 
02/19/2026
CLINDAMYCIN 300MG (CAP)
02/19/2026
02/26/2026
PO
1 Cap
Q8
SP Curettage
Remove - Pending Acceptance

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: