Gaviola, June Mae P.

HRN: 22-21-65  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/25/2022
AMPICILLIN 1GM (VIAL)
11/25/2022
11/26/2022
IV
2g
Q6
PROM
Waiting Final Action 
11/26/2022
CEFUROXIME 1.5GM (VIAL)
11/26/2022
12/03/2022
IVTT
1.5g
Q8
S/p Ltcs
Waiting Final Action 
11/27/2022
CEFUROXIME 500MG (TAB)
11/27/2022
12/04/2022
ORAL
500mg/tab
BID
S/P Repeat LTCS
Waiting Final Action 

AMS Audit Form


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Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: