Lacdayeng, Jack Cyves .

HRN: 29-01-76  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/14/2026
AMPICILLIN 500MG (VIAL)
05/14/2026
05/21/2026
IVT
125mg
Q6
PCAP-C
Checking Initial Appropriateness 
05/14/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/14/2026
05/21/2026
IVT
25mg
Q8
PCAP-C
Checking Initial Appropriateness 
05/22/2026
CEFUROXIME 750MG (VIAL)
05/22/2026
05/29/2026
IV
163mg
Q8H
PCAP C
Checking Initial Appropriateness 
05/24/2026
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
05/24/2026
05/31/2026
PO
1ml
QID
T/C Oral Candidiasis
Checking Initial Appropriateness 
05/24/2026
CEFTRIAXONE 1G (VIAL)
05/24/2026
05/31/2026
IV DRIP
490mg
OD
PCAP
Checking Initial Appropriateness 
05/28/2026
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
05/28/2026
06/04/2026
ORAL
1.5ml
OD
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: