Padilla, Lara .

HRN: 24-77-80  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/02/2024
CEFTRIAXONE 1G (VIAL)
06/02/2024
06/02/2024
IM
250mg
Now
STI
Waiting Final Action 
06/02/2024
AZITHROMYCIN 500MG TABLET (TAB)
06/02/2024
06/02/2024
PO
1g
Now
STI
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: