Lumingkit, Emma D.

HRN: 13-73-84  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/14/2023
CEFTRIAXONE 1G (VIAL)
09/14/2023
09/20/2023
IV
2g
OD
UTI
Waiting Final Action 
09/15/2023
AZITHROMYCIN 500MG TABLET (TAB)
09/15/2023
09/19/2023
ORAL
500mg
OD
CAP LR
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: