Ripo, Neri .

HRN: 04-97-07  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/02/2024
CEFTRIAXONE 1G (VIAL)
04/02/2024
04/08/2024
IVT
2g
OD
CAP MR
Checking Final Appropriateness 
04/02/2024
AZITHROMYCIN 500MG TABLET (TAB)
04/02/2024
04/04/2024
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: