Real, Teofilo, Jr. M.

HRN: 23-01-51  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/10/2023
CEFTRIAXONE 1G (VIAL)
05/10/2023
05/18/2023
IV
2gmd
OD
UTI
Waiting Final Action 
05/23/2023
CEFTAZIDIME 1GM (VIAL)
05/23/2023
05/30/2023
IV
1g
TID
Culture-directed
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: