Monterola, Lorito V.

HRN: 26-42-98  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/04/2025
CEFTRIAXONE 1G (VIAL)
04/04/2025
04/10/2025
IVTT
2g
OD
Cap-MR
Waiting Final Action 
04/04/2025
AZITHROMYCIN 500MG TABLET (TAB)
04/04/2025
04/08/2025
PO
500 Mg/tab, 1 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:



 If inappropriate:

              

Overall appropriateness: