Dizon, Ciwhan .

HRN: 14-56-35  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/02/2026
CEFTRIAXONE 1G (VIAL)
04/02/2026
04/09/2026
IV
1g
Q12h
R/O CNSI
Remove - Pending Acceptance
04/04/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
04/04/2026
04/11/2026
IV DRIP
1g
Q6
Acute Tonsillitis
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: