Lumantam, Ruel D.

HRN: 29-14-35  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/13/2026
CEFTRIAXONE 1G (VIAL)
06/13/2026
06/20/2026
IV
2g
Q24
ACUTE APPENDICITIS
Checking Initial Appropriateness 
06/13/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
06/13/2026
06/20/2026
IV
500 MG
Q8
ACUTE APPENDICITIS
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: