Ponio, Gilbert R.

HRN: 24-30-99  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/28/2023
CEFTRIAXONE 1G (VIAL)
12/28/2023
01/04/2024
IV
2gms
OD
CAP MR
Checking Final Appropriateness 
12/28/2023
AZITHROMYCIN 500MG TABLET (TAB)
12/28/2023
01/04/2024
PO
500mg
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: