Balili, Quirino B.

HRN: 26-68-47  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/13/2025
AZITHROMYCIN 500MG TABLET (TAB)
02/13/2025
02/17/2025
PO
500mg
OD
CAP MR
Waiting Final Action 
02/13/2025
CEFTRIAXONE 1G (VIAL)
02/13/2025
02/19/2025
IVT
2g
OD
CAP MR
Waiting Final Action 
02/26/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/26/2025
03/05/2025
IV
4.5
Q8
CAP MR
Rejected 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: