Gomez, Senicio P.

HRN: 02-50-34  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/24/2025
CEFTRIAXONE 1G (VIAL)
01/24/2025
01/30/2025
IV
2g
Once Daily
CAPMR
Waiting Final Action 
01/24/2025
AZITHROMYCIN 500MG TABLET (TAB)
01/24/2025
01/28/2025
PO
500mg OD
Once Daily
Pneumonia
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: