Butac, Clark Gie G.

HRN: 29-23-29  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/03/2026
CEFTRIAXONE 1G (VIAL)
07/03/2026
07/10/2026
IVT
500mg
OD
AGE W/ Severe Dehydration
Checking Initial Appropriateness 
07/05/2026
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
07/05/2026
07/11/2026
ORAL
3ml
TID
AGE
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: