Capas, Emilio .

HRN: 23-95-20  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/26/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/26/2023
10/30/2023
PO
500mg
OD
CAP-MR
Checking Final Appropriateness 
10/26/2023
CEFTRIAXONE 1G (VIAL)
10/26/2023
11/02/2023
IV
1g
BID
CAP-MR
Checking Final Appropriateness 
10/28/2023
AZITHROMYCIN 500MG TABLET (TAB)
10/28/2023
11/02/2023
IV
1 Tab
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: