Gonzaga, Leslie Mae .

HRN: 29-19-32  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/17/2026
CEFUROXIME 1.5GM (VIAL)
06/17/2026
06/17/2026
IV
1.5g
PTOR
D&C
Checking Initial Appropriateness 
06/17/2026
CLINDAMYCIN 300MG (CAP)
06/17/2026
06/23/2026
ORAL
300mg
TID
Sp Completion Curretage
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: