Diana, Jed Israel L.

HRN: 19-85-28  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/05/2022
AMPICILLIN 500MG (VIAL)
12/05/2022
12/12/2022
IV
340mg
Q6hrs
PCAP-C
Waiting Final Action 
01/01/2023
CEFTRIAXONE 1G (VIAL)
01/01/2023
01/07/2023
IV
1g
OD
PCAP C
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: