Gumen, Narciso .

HRN: 11-83-41  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/08/2022
CEFTRIAXONE 1G (VIAL)
10/08/2022
10/14/2022
IVT
2g
OD
UTI
Waiting Final Action 
10/14/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
10/14/2022
10/21/2022
IV
500mg
Q8h
Intraabdominal Infection
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

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 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: