Albellar, Mark Lloyd S.

HRN: 07-58-58  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/08/2022
CEFTRIAXONE 1G (VIAL)
05/08/2022
05/15/2022
IV
2g
Od
Asa:ap
Waiting Final Action 
05/08/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
05/08/2022
05/15/2022
IV
500mg
Q8
Asa:ap
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: