Dagooc, Francisco C.

HRN: 24-01-84  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/01/2023
CEFTRIAXONE 1G (VIAL)
11/01/2023
11/07/2023
IVTT
2g
OD
Cap MR
Checking Final Appropriateness 
11/01/2023
AZITHROMYCIN 500MG TABLET (TAB)
11/01/2023
11/05/2023
ORAL
500 Mg
OD
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: