Cabigon, Christen .

HRN: 28-54-86  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/14/2026
AMPICILLIN 1GM (VIAL)
03/14/2026
03/20/2026
IV
2 Grams
Q6
PROM
Checking Initial Appropriateness 
03/15/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
03/15/2026
03/22/2026
IVTT
900mg
Q8h
PROM X 31 Hours
Checking Initial Appropriateness 
03/16/2026
CO-AMOXICLAV 625MG (TAB)
03/16/2026
03/22/2026
ORAL
625mg
BID
PROM
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: