Arog, Crispina B.

HRN: 10-84-89  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/26/2024
CEFTRIAXONE 1G (VIAL)
08/26/2024
09/02/2024
IV
2g
Od
Cap Mr
Waiting Final Action 
08/26/2024
AZITHROMYCIN 500MG TABLET (TAB)
08/26/2024
09/02/2024
PO
500mg Tab
Od
CAP MR
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: