Ambalong, Reyna Jane .

HRN: 03-24-92  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/29/2026
CEFAZOLIN 1GM (VIAL)
05/29/2026
05/29/2026
IV
2gms
PTOR
STAT CS
Checking Initial Appropriateness 
05/29/2026
CEFUROXIME 500MG (TAB)
05/29/2026
06/03/2026
PO
500mg
BID X 5 Days
S/p LTCS With IUD
Checking Initial Appropriateness 
05/29/2026
CEFUROXIME 500MG (TAB)
05/29/2026
06/04/2026
PO
500 Mg
BID
Sp 1 LTCS
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: