Mamucan, Loreto P.

HRN: 27-35-53  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/20/2025
CEFTAZIDIME 1GM (VIAL)
06/20/2025
06/26/2025
IV
1g
Q8h
CAP-MR
Remove - Pending Acceptance
06/20/2025
AZITHROMYCIN 500MG TABLET (TAB)
06/20/2025
06/24/2025
PO
500mg
Od
Cap-Mr
Remove - Pending Acceptance

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: