Ampalo, Rosina L.

HRN: 27-74-63  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/04/2025
AZITHROMYCIN 500MG TABLET (TAB)
09/04/2025
09/08/2025
PO
500
OD
CAP LR
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: