Nacuda, Glory Belle D.

HRN: 05-41-50  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/06/2022
AMPICILLIN 1GM (VIAL)
10/06/2022
10/13/2022
IVT
2grams
Q6h
PROM X 19hrs
Waiting Final Action 
10/08/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
10/08/2022
10/14/2022
IV
1vial
Q8H
S/p LTCS
Waiting Final Action 
10/10/2022
CEFUROXIME 500MG (TAB)
10/10/2022
10/16/2022
PO
1 Tab
Q12H
S/p LTCS
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: