Vega, Ronelito L.

HRN: 22-54-74  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/15/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/15/2026
06/21/2026
IV
490mg
Q6
PCAP C
Checking Initial Appropriateness 
06/18/2026
CEFUROXIME 750MG (VIAL)
06/18/2026
06/25/2026
IV
450mg
Q8
PCAP-C
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: