Marmojada, Conrada C.

HRN: 24-79-10  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/07/2024
CEFTRIAXONE 1G (VIAL)
04/07/2024
04/13/2024
IVTT
2g
OD
Cap-MR Uti
Checking Final Appropriateness 
04/07/2024
AZITHROMYCIN 500MG TABLET (TAB)
04/07/2024
04/11/2024
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: