Bala, Renato T.

HRN: 05-78-11  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/02/2022
CEFTRIAXONE 1G (VIAL)
05/02/2022
05/08/2022
IV
1g
Once A Day
PCAP C
Waiting Final Action 
05/04/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/04/2022
05/10/2022
IVT
285mg
Q12
Pcap C

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: