Cumba, William A.

HRN: 01-77-09  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/28/2023
CEFTRIAXONE 1G (VIAL)
09/28/2023
10/05/2023
IV
2gms
OD
CAP MR
Checking Final Appropriateness 
10/01/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/01/2023
10/05/2023
PO
500mgtab
Q24
Cap Mr
Checking Final Appropriateness 

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: