Catubig, Rogelio C.

HRN: 20-84-65  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/13/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/13/2023
10/17/2023
PO
1 Tab
OD
Cap Lr
Checking Final Appropriateness 
10/13/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/13/2023
10/17/2023
PO
1 Tab
OD
Cap Lr
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: