Andrin, Jazel B.

HRN: 29-21-74  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/26/2026
AMPICILLIN 500MG (VIAL)
06/26/2026
06/26/2026
IV
2 Grams
Q6
PROM X 8 Hrs
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: