Copio, Pablita S.

HRN: 29-34-34  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/24/2026
CEFTRIAXONE 1G (VIAL)
07/24/2026
07/30/2026
IV
2g
OD
UTI
Remove - Pending Acceptance
07/25/2026
CIPROFLOXACIN 2MG/ML, 100ML IV
07/25/2026
08/01/2026
IV
400mg
Q12
UTI
Remove - Pending Acceptance

AMS Audit Form


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Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: