Gemena, Ramel .

HRN: 28-90-97  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/28/2026
CEFTRIAXONE 1G (VIAL)
04/28/2026
05/05/2026
IV ( ) ANST
2 Gm
OD
Infected Lateral Neck Mass
Checking Initial Appropriateness 
04/28/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
04/28/2026
05/05/2026
IV
600 Mg
Q 6h
Infected Lateral Neck Mass
Checking Initial Appropriateness 
05/07/2026
COTRIMOXAZOLE 960MG (TAB)
05/07/2026
05/28/2026
PO
960mg
OD
Disseminated TB
Checking Initial Appropriateness 
05/10/2026
COTRIMOXAZOLE 960MG (TAB)
05/11/2026
05/15/2026
PO
980
OD
Disseminated Tb
Checking Initial Appropriateness 
05/15/2026
COTRIMOXAZOLE 960MG (TAB)
05/15/2026
05/21/2026
PO
960mg
OD 3x/week
Dessiminated TB
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: