Inidal, Sarilingan S.

HRN: 23-82-93  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/03/2023
CEFTRIAXONE 1G (VIAL)
10/03/2023
10/09/2023
IV
1 Gram
Q12
Cap Mr
Waiting Final Action 
10/03/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/03/2023
10/07/2023
ORAL
1 Tab
OD
5 Days
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: