Cupino, Gabriel Nash C.

HRN: 24-44-65  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/29/2025
CEFTRIAXONE 1G (VIAL)
01/29/2025
02/05/2025
SLOW IV DRIP
2 Grams
Q24
Asthma
Rejected 
01/30/2025
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
01/30/2025
02/06/2025
PO
6 Ml
Q 24
BA T/C URTI
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: