Pangansayan, Yashmen H.

HRN: 24-21-20  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/30/2023
CEFTRIAXONE 1G (VIAL)
11/30/2023
12/07/2023
IV
2g
Q24
Uti
Waiting Final Action 
12/06/2023
AZITHROMYCIN 500MG TABLET (TAB)
12/06/2023
12/11/2023
PO
1 Tab
OD
T/c Sepsis
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: