Omay, Ponciano .

HRN: 23-78-59  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/27/2023
AZITHROMYCIN 500MG TABLET (TAB)
09/27/2023
10/01/2023
PO
500mg
OD
CAP-MR
Checking Final Appropriateness 
09/27/2023
CEFTRIAXONE 1G (VIAL)
09/27/2023
10/04/2023
IV
2g
OD
CAP-MR
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: