Yuag, Qiana Mae .

HRN: 29-27-82  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/08/2026
AMPICILLIN 250MG (VIAL)
07/08/2026
07/14/2026
IV
160mg
Q12
MAP
Checking Initial Appropriateness 
07/08/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/08/2026
07/14/2026
IV
48mg
Q24
MAP
Checking Initial Appropriateness 
07/12/2026
CEFTAZIDIME 1GM (VIAL)
07/12/2026
07/19/2026
IVTT
160mg
Q12h
MAP, PSNB
Checking Final 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: