Canizares, Marites .

HRN: 27-29-45  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/26/2025
AMPICILLIN 1GM (VIAL)
06/26/2025
07/03/2025
PO
2g
Q6h
PPROM
Waiting Final Action 
06/26/2025
AZITHROMYCIN 500MG TABLET (TAB)
06/26/2025
07/03/2025
PO
500mg
OD
PPROM
Remove - Pending Acceptance
06/27/2025
CEFUROXIME 500MG (TAB)
06/27/2025
07/04/2025
PO
1 Tab
BID
S/P NSD
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: