Gon, Berto L.

HRN: 03-73-31  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/15/2025
CEFTRIAXONE 1G (VIAL)
08/15/2025
08/21/2025
IV
2 Grams
Od
Cap Mr
Checking Initial Appropriateness 
08/15/2025
AZITHROMYCIN 500MG TABLET (TAB)
08/15/2025
08/17/2025
PO
500
OD
Pneumonia
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: