Agawin, Romel G.

HRN: 22-07-78  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/20/2022
CEFTRIAXONE 1G (VIAL)
10/20/2022
10/27/2022
IV
2g
OD
Complicated UTI
Waiting Final Action 
10/22/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/22/2022
10/28/2022
IV
1g
Q24H
Acute Complicated Urinary Tract Infection
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: