Pahilagao, Loreto, JR.. M.

HRN: 24-37-34  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/06/2024
CEFTRIAXONE 1G (VIAL)
01/06/2024
01/12/2024
IVTT
2g
Od
Cap-MR
Checking Final Appropriateness 
01/06/2024
AZITHROMYCIN 500MG TABLET (TAB)
01/06/2024
01/10/2024
PO
500 Mg/tab, 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: