Rica, Lorimae S.

HRN: 22-05-84  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/08/2022
AMPICILLIN 1GM (VIAL)
10/08/2022
10/15/2022
IV
2grams
Q6h
PROM
Waiting Final Action 
10/09/2022
CEFUROXIME 500MG (TAB)
10/09/2022
10/16/2022
ORAL
1 Tab
BID
S/P NSVD PROM X 10hrs
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: