Dapitan, Divine Grace P.

HRN: 16-00-32  Sex: Female

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
06/19/2026
IV
2g
Od
Uti
Checking Initial Appropriateness 
06/21/2026
NITROFURANTOIN 100MG CAP
06/21/2026
06/23/2026
PO
100mg
BID
Cystitis
Checking Initial Appropriateness 
06/23/2026
CEFTRIAXONE 1G (VIAL)
06/23/2026
06/29/2026
IV
2g
Q24
Cystitis
Checking Initial Appropriateness 
06/25/2026
CEFIXIME 200MG (CAP)
06/25/2026
07/02/2026
PO
200mg
BID
UTI
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: