Gutierrez, Khent Andrey C.

HRN: 19-63-18  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/08/2026
CEFTRIAXONE 1G (VIAL)
03/08/2026
03/15/2026
IV
1.4g
Q24h
PCAP-C
Checking Initial Appropriateness 
03/11/2026
CEFIXIME 100MG/5ML, 60ML SUSPENSION (BOT)
03/11/2026
03/16/2026
ORAL
3ml
Q12
PCAP-C
Checking Initial Appropriateness 
03/11/2026
CEFUROXIME 250MG/5ML, 50ML SUSPENSION (BOT)
03/11/2026
03/17/2026
ORAL
4ml
Q12
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: