Sagga, Jade T.

HRN: 21-75-46  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/21/2025
CEFTRIAXONE 1G (VIAL)
05/21/2025
05/27/2025
IV
2g
OD
Cap MR
Waiting Final Action 
05/21/2025
AZITHROMYCIN 500MG TABLET (TAB)
05/21/2025
05/25/2025
PO
500mg
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:



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Overall appropriateness: