Gallano, Placida .

HRN: 27-20-97  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/31/2025
CIPROFLOXACIN 500MG (TAB)
05/31/2025
06/02/2025
PO
500 Mg
BID
Acute Infection Diease
Checking Initial Appropriateness 
06/01/2025
CEFTAZIDIME 1GM (VIAL)
06/01/2025
06/07/2025
IVT
2g
Q8H
HAP
Waiting Final Action 
06/01/2025
LEVOFLOXACIN 500MG (TAB)
06/01/2025
06/05/2025
ORAL
500mg
OD
HAP
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: