Mancha, Roy A.

HRN: 22-29-11  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/02/2024
AZITHROMYCIN 500MG TABLET (TAB)
05/02/2024
05/06/2024
PO
500mg
OD
Massive Hemoptysis Sec To PTB
Waiting Final Action 
05/06/2024
LEVOFLOXACIN 500MG (TAB)
05/06/2024
05/13/2024
ORAL
500mg
OD
Massive Hemoptysos Sec To PTB
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: