Paraiso, Jhon Arl G.

HRN: 22-86-31  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/12/2023
AMPICILLIN 250MG (VIAL)
04/12/2023
04/19/2023
IV
170mg
Q6
PCAP C
Waiting Final Action 
04/12/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
04/12/2023
04/19/2023
IV
7.5mg
Q8
PCAP C
Waiting Final Action 
04/13/2023
CEFTRIAXONE 1G (VIAL)
04/13/2023
04/19/2023
IV
450
Q24
PCAP Severe
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: