Bacariza, Teodora .

HRN: 16-49-72  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/31/2025
CEFTRIAXONE 1G (VIAL)
08/31/2025
09/07/2025
IVTT
2gms
OD
CAP MR
Checking Initial Appropriateness 
08/31/2025
AZITHROMYCIN 500MG TABLET (TAB)
08/31/2025
09/05/2025
PO
500MG
OD
CAP MR
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: