Asma, Lesley Anya M.

HRN: 26-92-64  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/22/2026
CEFUROXIME 1.5GM (VIAL)
02/22/2026
03/01/2026
IV
400mg
Q8h
PCAP C
Checking Initial Appropriateness 
02/22/2026
CEFTRIAXONE 1G (VIAL)
02/22/2026
03/01/2026
IV
1.2g
Q24h
Pcap C
Checking Initial Appropriateness 
02/25/2026
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
02/25/2026
03/04/2026
PO
2ml
Q8
PCAP
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: