Mana, Remee Jr. B.

HRN: 06 19 96  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/17/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/17/2022
05/24/2022
IV
1.5gm
Q6
Infected Wound
Waiting Final Action 
05/17/2022
CO-AMOXICLAV 625MG (TAB)
05/17/2022
05/24/2022
PO
625
TID
Infected Wound
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: