Tanog, Marry Jane T.

HRN: 28-68-64  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/10/2026
AMPICILLIN 1GM (VIAL)
03/10/2026
03/11/2026
IV
2 Grams
Q6
THINLY MSAF
Remove - Pending Acceptance
03/10/2026
CEFUROXIME 500MG (TAB)
03/10/2026
03/16/2026
PO
1tab
Bid
Thickly Msaf
Remove - Pending Acceptance
03/10/2026
METRONIDAZOLE 500MG (TAB)
03/10/2026
03/16/2026
PO
1tab
Tid
Thickly
Remove - Pending Acceptance

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: