Etol, Juditha B.

HRN: 27-05-39  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/30/2025
CEFTRIAXONE 1G (VIAL)
04/30/2025
05/06/2025
IVTT
2g
Once A Day
CAP-MR
Waiting Final Action 
04/30/2025
AZITHROMYCIN 500MG TABLET (TAB)
04/30/2025
05/06/2025
ORAL
500mg
Once A Day
CAP-MR
Waiting Final Action 
05/02/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/02/2025
05/08/2025
IV
1.5gm
Q12
Cap Mr
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: