Templa, Niceforo P.

HRN: 21-51-29  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/16/2023
CEFTRIAXONE 1G (VIAL)
05/16/2023
05/22/2023
IV
2g
OD
CAP-MR
Waiting Final Action 
05/16/2023
AZITHROMYCIN 500MG TABLET (TAB)
05/16/2023
05/20/2023
PO
500mg
OD
CAP-MR
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: